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First draft for Industry release Occupational Health and Safety for Cabin Crew and Flight Crew

w 24/02/09

Occupational Health and Safety for Cabin Crew and Flight Crew
AGuidelineforHealthandSafetyOnboardAircraft

DRAFT

Health and Safety in Employment Unit Civil Aviation Authority of New Zealand

First draft for Industry release Occupational Health and Safety for Cabin Crew and Flight Crew 24/02/09

Disclaimer This Guide is only a general guide to the Health and Safety in Employment Act 1992. It should not be used as a substitute for the Act itself. The Civil Aviation Authoritys Health and Safety in Employment Unit, in providing advice on the administration of the Health and Safety in Employment Act 1992, is not to be taken as defining or providing a definitive interpretation of the relevant parts, sections or subsections of the Act. Ultimately, questions of interpretation in a particular case will always be a matter for the Courts to decide. Therefore, any advice given is intended as a guide and you are advised to carefully consider the express provisions of the Act itself. Without limiting the above, you are advised that: 1. The information provided is of a general nature only, and is not intended to address specific circumstances of any particular individual or entity. 2. The Civil Aviation Authority makes no warranties, guaranties or undertakings as to results that may be obtained from information contained in this Guide. The information provided is not professional or legal advice. Specific advice should be sought from qualified professionals prior to relying on any information. The information provided is not in substitution or in any way an alteration to the laws of New Zealand or any other official guidelines or requirements. Copyright This Guideline is the copyright of the Civil Aviation Authority and may be reproduced for personal use free of charge in any format or media without requiring specific permission. This is subject to the Civil Aviation Authoritys copyright being acknowledged and the material being reproduced accurately and not being used in a derogatory manner or in a misleading context. For permission to reproduce information in this Guideline for any purpose other than personal use please contact the Civil Aviation Authority. The permission to reproduce copyright protected material does not extend to any material within the Guideline that is identified as being the copyright of a third party. Authorisation to produce such material must be obtained from the copyright holders concerned.

First draft for Industry release Occupational Health and Safety for Cabin Crew and Flight Crew 24/02/09

Foreword It is with pleasure that I introduce this Guideline for Health and Safety On-board Aircraft. It provides information and guidance to employers, aircraft operators, cabin crew and flight crew of aircraft. The Guideline focuses on occupational health and safety hazards specific to crew members who work in the aircraft, rather than on flight safety hazards already dealt with by aviation regulatory standards and guidance. Accidents and incidents seldom have a single cause; there are often multiple contributing factors. The information in this Guideline will help employers, aircraft operators, cabin crew and flight crew to better identify hazards in the workplace, and give them guidance on how to manage hazards to reduce the risk of harm. The guideline aims to: Assist in identifying hazards systematically (hazard identification). Assist in identifying activities where injury or harm could occur (identifying potentially hazardous activities). Assist industry groups to determine how likely it is that injury or harm will happen (risk assessment). Provide information that will help protect cabin crew and flight crew in their workplace. (Safety Information). This guideline has been developed by the Civil Aviation Authority of New Zealand in consultation with representatives from the Aviation Sector, the Accident Compensation Corporation and Union Groups. Adopting this Guideline will help to ensure that the hazards to which cabin crew and flight crew are exposed to, are managed to reduce the risk of injury and illness, and will assist towards meeting the legal requirements under the Health and Safety in Employment Act 1992 (the Act).

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Signature of Minister:

First draft for Industry release Occupational Health and Safety for Cabin Crew and Flight Crew 24/02/09

Contents
Scope .................................................................................................................... 7 Consultation and Review .................................................................................... 7 Introduction ......................................................................................................... 9 Primary Objective ................................................................................................ 9 Definitions .......................................................................................................... 10 Abbreviations .................................................................................................... 16 Section One General Duties under the Health and Safety in Employment Act 1992 ..................................................................................... 18 1.1 General Duties of Employers ................................................................................. 18 1.2 Hazard Management Including Risk Management................................................ 19 1.3 All Practicable Steps .............................................................................................. 20 1.4 Accident/Incident Reporting and Investigation ..................................................... 21 1.5 Serious Harm Investigation and Reporting ............................................................ 21 1.6 Investigation Reports ............................................................................................. 21 1.7 Employee Responsibilities ..................................................................................... 22 1.8 Hazards/Incidents Crew Members Should Report ................................................. 23 1.9 Duties of Employees .............................................................................................. 23 1.10 Duties of Employers to People Who Are Not Employees ................................... 24 1.11 Duties of Principals .............................................................................................. 24 Section Two Cabin Environment .................................................................. 26 2.1 Manual Handling ................................................................................................... 26 2.2 Handling of Cabin Baggage ................................................................................... 27 Employer Responsibilities ................................................................................... 27 Employee Responsibilities ................................................................................... 28 Recommendations ................................................................................................ 29 2.3 Turbulence ............................................................................................................. 30 Hazards Associated with Turbulence ................................................................... 31 Turbulence Guidance ........................................................................................... 31 Design Safeguards................................................................................................ 34 Employer Responsibilities ................................................................................... 34 Employee Responsibilities ................................................................................... 35 Recommendations ................................................................................................ 35 2.4 Slips, Trips and Falls ............................................................................................. 36 Employer Responsibilities ................................................................................... 36 Employee Responsibilities ................................................................................... 37 Recommendations ................................................................................................ 37 2.5 Air Quality Onboard Aircraft ................................................................................ 37 Employer Responsibilities ................................................................................... 37 Employee Responsibilities ................................................................................... 38 Recommendations ................................................................................................ 38 2.6 Unruly or Disruptive Passengers ........................................................................... 39 Passenger Psychiatric Illness................................................................................ 39 Violent Passengers/Passenger Restraint ............................................................... 39 Employer Responsibilities ................................................................................... 40 Employee Responsibilities ................................................................................... 41 Recommendations ................................................................................................ 41 2.7 Dangerous Goods................................................................................................... 41 Information to PIC ............................................................................................... 41 Information to Employees .................................................................................... 42 Examples of Dangerous Goods Incidents ............................................................ 43 Employer Responsibilities ................................................................................... 43 Employee Responsibilities ................................................................................... 44 Recommendations ................................................................................................ 44
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Section Three Galley Operation and Service Provision ............................. 45 3.1 Food and Beverage Handling, and In-Flight Equipment ....................................... 45 3.2 Food and Beverage Carts/Trolleys......................................................................... 45 3.3 Maintenance of InFlight Equipment .................................................................... 45 Information and Training ..................................................................................... 46 Employer Responsibilities ................................................................................... 46 Employee Responsibilities ................................................................................... 46 Recommendations ................................................................................................ 47 3.4 Burns and Scalds.................................................................................................... 47 Hazards ........................................................................................................ `47 Employer Responsibilities ................................................................................... 48 Employee Responsibilities ................................................................................... 48 Recommendations ................................................................................................ 48 Section Four Crew Health and Wellbeing .................................................... 49 4.1 Crew Health ........................................................................................................... 49 Employer Responsibilities ................................................................................... 49 Employee Responsibilities ................................................................................... 49 Recommendations ................................................................................................ 50 4.2 Biological Hazards to Crew Health ....................................................................... 50 Sources of Biological Hazards ............................................................................. 50 Pandemics and Epidemics .................................................................................... 51 Employer Responsibilities ................................................................................... 51 Employee Responsibilities ................................................................................... 52 Recommendations ................................................................................................ 53 4.3 Hearing Conservation in the Workplace ................................................................ 53 Effects of Noise on Hearing ................................................................................. 54 Occupational Deafness ......................................................................................... 55 Employer Responsibilities ................................................................................... 55 Employee Responsibilities ................................................................................... 56 Recommendations ................................................................................................ 56 Noise Level Figures ............................................................................................. 56 4.4 Stress ................................................................................................................... 57 Employer Responsibilities ................................................................................... 58 Employee Responsibilities ................................................................................... 58 Recommendations ................................................................................................ 58 4.5 Fatigue ................................................................................................................... 59 The Body Clock ................................................................................................... 59 Causes of Fatigue ................................................................................................. 60 Signs and Symptoms of Fatigue ........................................................................... 61 Personal Strategies for Minimising Fatigue ......................................................... 63 Organisational Strategies for Minimising Fatigue ............................................... 66 Employer Responsibilities ................................................................................... 68 Employee Responsibilities ................................................................................... 68 Recommendations ................................................................................................ 69 4.6 Drugs and Alcohol ................................................................................................. 69 Employer Responsibilities ................................................................................... 70 Employee Responsibilities ................................................................................... 70 Recommendations ................................................................................................ 71 4.7 Bullying and Harassment ....................................................................................... 71 Employer Responsibilities ................................................................................... 71 Employee Responsibilities ................................................................................... 71 Recommendations ................................................................................................ 72

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Section Five Training and Emergency Response ....................................... 73 5.1 Training.................................................................................................................. 73 Cabin Crew Members .......................................................................................... 73 Types of Training ................................................................................................. 74 Employer Responsibilities ................................................................................... 74 Employee Responsibilities ................................................................................... 75 Recommendations ................................................................................................ 75 5.2 Crew Resource Management (CRM) and Team Performance .............................. 75 Employer Responsibilities ................................................................................... 77 Employee Responsibilities ................................................................................... 78 Recommendations ................................................................................................ 78 5.3 Emergency and Safety Procedures, Cabin Crew Briefings and Passenger Briefings ............................................................................................................ 78 Emergency Situations .......................................................................................... 78 Safety manual Emergency Procedures Format .................................................... 79 Cabin crew Briefings ........................................................................................... 79 Employer Responsibilities ................................................................................... 79 Employee Responsibilities ................................................................................... 80 Recommendations ................................................................................................ 80 5.4 Aviation Medicine First Aid Training and Equipment ....................................... 80 Employer Responsibilities ................................................................................... 81 Employee Responsibilities ................................................................................... 82 Recommendations ................................................................................................ 82 References ......................................................................................................... 83

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Scope
This guideline provides health and safety guidance to employers, aircraft operators, cabin crew and flight crew. It focuses on specific occupational hazards, relevant to all crew members that exist on board aircraft. The guideline is largely best practice rather than mandatory in nature. Agencies investigating incidents and accidents may use this guideline when conducting investigations.

Consultation and Review


It is intended to be a living document. It will be regularly reviewed and updated by the Civil Aviation Authority of New Zealand (CAA) and the consultation group below. Acknowledgments: The following organisations and personnel contributed to the preparation and development of this guideline. CAA groups as follows: Health and Safety in Employment Unit (HSE Unit) Personnel Licensing and Aviation Services Group Airlines Group Aircraft Certification Unit Safety Investigation Unit Communications and Safety Education Unit Library Section Business Support Unit Human Resources Legal Unit Government Services External Organisations: Asia - Pacific Cabin Safety Working Group Flight Attendants and Related Services Association - ( FARSA ) N.Z. Airline Services Society Inc. ( Pegasus ) Jetconnect Ltd Pacific Blue Airlines (NZ) Limited Air Nelson Limited

First draft for Industry release Occupational Health and Safety for Cabin Crew and Flight Crew 24/02/09

Air New Zealand Limited Airwork Holdings Limited Airwork Flight Operations Aviation Industry Association of NZ (Inc) New Zealand Air Line Pilots Association ( Inc ) Accident Compensation Corporation- Injury Prevention and Client Services Aviation, Tourism & Travel Training Organisation Massey University Wellington - Sleep / Wake Research Centre

First draft for Industry release Occupational Health and Safety for Cabin Crew and Flight Crew 24/02/09

Introduction
The Workplace Health and Safety Strategy for New Zealand to 2015 (WHSS) provides a framework for the workplace health and safety initiatives of government agencies, local governments, unions, employer and industry organisations, other nongovernment organisations and workplaces. As a designated agency for administering the Health and Safety in Employment Act 1992 (the Act), the CAA has specific responsibilities for implementing the WHSS Action Plan 2005/2006. Some of these responsibilities include, continuing to work with industry to develop standards, provide practical guidance, and develop and distribute information products to address priorities. Since its designation in 2003, the CAA has recorded an increase in the number of concerns and reports of injury from companies, unions, and individual crew members relating to issues such as fatigue, slips, trips and falls, scalds, and limb and back injuries caused by lifting weights and manoeuvring service carts in turbulent conditions. The CAAs designation to administer the provisions of the Act, imparts a responsibility for promoting and improving health and safety of cabin crew and flight crew working on board an aircraft in operation. Under the Act, there are several tools that may be used by the CAA to intervene in order to improve health and safety of cabin and flight crew members. These include Approved Codes of Practice and Safety Guidelines. Approved Codes of Practice are prescriptive documents similar to the Civil Aviation Rules, while Safety Guidelines are similar to Advisory Circulars. Given the wide range of issues that need to be covered in the case of all crew members, the CAA believes that the production of this Safety Guideline is the best way to address the identified issues.

Primary Objective
The primary objective of this guideline is to reflect the purpose of the Act, which is to provide systematic management of health and safety for persons at work. It requires air operators and crew members to maintain safe working environments and to implement best practice health and safety work methods. Following this guideline will assist towards meeting these legal requirements under the Act.

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Definitions
For the purpose of this guideline, the following definitions apply. Adequate rest facilities: Means rest facilities considered by the Director of Civil Aviation to be sufficiently segregated and comfortable so as to provide suitable rest for resting flight crew members, having regard to the service concerned. Air operator: Means an organisation certified and approved by an aviation regulatory authority to conduct air transport or commercial transport operations e.g. an airline. All practicable steps: This is defined as follows in section 2A of the Act: s2A All practicable steps (1)In this Act, all practicable steps, in relation to achieving any result in any circumstances , means all steps to achieve the result that is reasonably practicable to take in the circumstances, having regard to(a) the nature and severity of the harm that may be suffered if the result is not achieved; and (b) the current state of knowledge about the likelihood that harm of that nature and severity will be suffered if the result is not achieved; and (c) the current state of knowledge about harm of that nature; and (d) the current state of knowledge about the means available to achieve the result, and about the likely efficacy of each of those means; and (e) the availability and cost of each of those means. (2) To avoid doubt, a person required by this Act to take all practicable steps is required to take those steps only in respect of circumstances that the person knows or ought reasonably to know about. Barototis: Means discomfort and swelling in the ear caused by changes in air pressure during travel. Cabin crew member: Means a crew member who performs, in the interest of safety of passengers, duties assigned by the operator or the pilot in command of the aircraft, but shall not act as a flight crew member. Circadian rhythm: Means the internal biological clock that regulates human physiological functions according to the time of day through external cues and is reset every 24 25 hours. Clear Air Turbulence (CAT): Means turbulence that is not predictable and cannot be detected which occurs in clear air, clear of clouds, and, usually without warning.

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Crew member: This is defined in Rule Part 1 of the Civil Aviation Rules as a person carried by an aircraft who is: (1) Assigned by the operator (i) as a flight crew member or flight attendant to perform a duty associated with the operation of the flight; or (ii) to perform a duty associated with the operation of the aircraft during flight time; or (2) carried for the sole purpose of (i) undergoing or giving instruction in the control and navigation of the aircraft; or (ii) undergoing instruction as a flight engineer or flight attendant; or (3) authorised by the Director to exercise a function associated with the operation of the aircraft during flight time; or (4) a flight examiner: Contractor: This is defined in section 2 of the Act as a person engaged by any person (otherwise than as an employee) to do any work for gain or reward. Crew Resource Management (CRM): Means a management concept to utilise and improve the resource management skills of flight crew, cabin crew and others in the aviation sector. Dangerous Goods: This is defined in Part 1 of the Civil Aviation Rules as articles or substances which are capable of posing a risk to health, safety, property or the environment and (a) are listed in, or classified in accordance with, the ICAOs Technical Instructions for the Safe Transport of Dangerous Goods by Air; or (b) have properties that would result in other articles or substances being classified as dangerous goods under the ICAOs Technical Instructions for the Safe Transport of Dangerous Goods by Air. 85dB (A): Means a sound pressure level. A - Weighted decibel. The A - weighting is that specified in International Standard IEC 60651. Designation: Means the designation which makes the CAA responsible for administering the Act in respect of work on board aircraft. This includes aircraft operations: In which there exists an employer/employee relationship between aircraft operators and those persons employed to work on board an aircraft Involving self-employed people Involving contract principals.

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Duty period: Means any continuous period throughout which a flight crew member is required by an operator to be on duty or available for duty, whether on the ground or in the air. Where a flight crew member is required by an operator to be on duty or available for duty for two or more periods separated by an interval of less than 10 hours, the periods shall be deemed continuous, starting when the first of the periods begins and finishing when the last period ends. Employee: This is defined in section 2 of the Act as subject to sections 3C to 3F, means any person of any age employed by an employer to do any work (other than residential work) for hire or reward, under a contract of service and, in relation to any employer, means an employee of the employer. Employer: This is defined in section 2 of the Act as (a) means a person who or that employs any other person to do any work for hire or reward; and, in relation to any employee, means an employer, subject to sections 3C to 3F, of the employee; and (b) includes, in relation to any person employed by the chief executive or other employee of a Crown organisation to do any work for the Crown organisation for hire or reward, that Crown organisation. The above definition covers persons working under contract of employment, apprenticeship or an industrial training agreement. Ergonomics: Means the study of the efficiency of persons in their working environment. It is often used by aircraft manufacturers and designers to refer to the study of human machine interaction. (eg. pilot cockpit, flight attendant galley, etc). Fatigue Risk Management System: Means an integrated safety management system designed to ensure crew alertness and performance is not impaired due to fatigue. Flight attendant: See cabin crew member: Flight crew member: This is defined in Part 1 of the Civil Aviation Rules as an appropriately qualified person assigned by the operator for duty in an aircraft during flight time as a pilot or flight engineer. Harm: This is defined in the section 2 of the Act as illness, injury or both; and includes physical or mental harm caused by work related stress. Hazard: This is defined in the section 2 of the Act as (a) means an activity, arrangement, circumstance, event, occurrence, phenomenon, process, situation, or substance (whether arising or caused within or outside a place of work) that is an actual or potential cause or source of harm; and

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(b) includes (i) a situation where a person's behaviour may be an actual or potential cause or source of harm to the person or another person; and (ii) without limitation, a situation described in subparagraph (i) resulting from physical or mental fatigue, drugs, alcohol, traumatic shock, or another temporary condition that affects a person's behaviour. Health education: Means providing information and teaching people how to behave safely and in a manner that promotes and maintains their health. Hearing protector: Means a device or pair of devices that have been tested to an appropriate national or international standard and classified (or graded) by a suitably equipped and independently audited laboratory with full traceability to National Standards. Such a device is worn by a person or inserted in the ears of a person to protect that person from exposure to noise. (IATA): International Air Transport Association: Means an international organisation which represents member airlines and air operators. Infectious disease (communicable disease): Means an illness, due to a specific infectious agent or its toxic products, that arises through transmission of that agent or its products from an infected person, animal or reservoir to a susceptible host. Line Orientated Flight Training: Means flight crew training which involves a full mission simulation of situations which involving communication, management, and leadership. It is considered to be the practical application of CRM training. Micro sleep: Means a brief uncontrollable nap that lasts for a few seconds, when the brain disengages from the environment and slips into light sleep. Micro sleeps result when the biological drive for sleep builds up to extreme levels. Mockup: Means a training device that is a partial, functional replica of an actual aircraft, without motion. Morbidity: Means illness, sickness. Mortality: Means death. Noise: Means any sound present in the workplace whether it is wanted or not, and includes sound energy of any frequency, whether or not it is able to be perceived by the unaided human ear. Operations manual: Means a manual containing procedures, instructions and guidance for use by operational personnel in the execution of their duties. Place of work: This is defined in section 2 of the Act as: a place (whether or not within or forming part of a building, structure, or vehicle) where any person is to work, is working, for the time being works, or customarily works, for gain or reward; and, in relation to an employee, includes a place, or part of a place, under the control of the employer (not being domestic accommodation provided for the employee),

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(a) Where the employee comes or may come to eat, rest, or get first-aid or pay; or (b) Where the employee comes or may come as part of the employee's duties report in or out, get instructions, or deliver goods or vehicles; or (c) Through which the employee may or must pass to reach a place of Plant: This is defined in section 2 of the Act as including (a) Appliance, equipment, fitting, furniture, implement, machine, machinery, tool, and vehicle; and (b) Part of any plant, the controls of any plant, and anything connected to any plant. This is a non exhaustive definition. Predictable turbulence: Means turbulence which is expected. Principal: This is defined in section 2 as a person who or that engages any person (otherwise than as an employee) to do any work for gain or reward. Rest period: Means any period of time on the ground during which a flight crew member is relieved of all duties by the operator. Risk: Means an expression of possible loss in terms of severity and frequency/probability. Risk assessment: Means the process of detecting hazards and determining risk. Risk control: Means the steps taken to eliminate hazards or to mitigate their effects by reducing severity and/or likelihood of risk associated with those hazards. Risk management: Means the application of a process which controls the risks associated with operations or tasks. Safe: This is defined in section 2 as: (a) In relation to a person, means not exposed to any hazards; and (b) In every other case, means free from hazards; and unsafe and safety have corresponding meanings Serious harm: This is defined in section 2 as: subject to subsection (4) of this section, means death, or harm of a kind described by the Governor-general by Order in Council to be serious for the purposes of this Act; and seriously harmed has a corresponding meaning. work: to

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The First Schedule to the Act lists the following as being serious harm: 1. Any of the following conditions that amounts to or results in permanent loss of bodily function, or temporary severe loss of bodily function: respiratory disease, noiseinduced hearing loss, neurological disease, cancer, dermatological disease, communicable disease, musculoskeletal disease, illness caused by exposure to infected material, decompression sickness, poisoning, vision impairment, chemical or hotmetal burn of eye, penetrating wound of eye, bone fracture, laceration, crushing. 2. Amputation of body part. 3. Burns requiring referral to a specialist medical practitioner or specialist outpatient clinic. 4. Loss of consciousness from lack of oxygen. 5. Loss of consciousness, or acute illness requiring treatment by a medical practitioner, from absorption, inhalation, or ingestion, of any substance. Shall: Means a recommendation that is mandatory for compliance with a statute. Shall includes must. Should: Means preferred practice or recommendation. Significant hazard: This is defined in section 2 of the Act as: a hazard that is an actual or potential cause or source of (a) serious harm; or (b) harm (being harm that is more than trivial) the severity of whose effects on any person depend (entirely or amongst other things) on the extent or frequency of the persons exposure to the hazard; or (c) harm that does not usually occur, or usually is not easily detectable, until a significant time after exposure to the hazard. Simulator: Means an apparatus which provides an accurate representation of the flight deck and /or cabin of a particular aircraft type to the extent that the mechanical, electrical, electronic, etc, aircraft systems control functions, the normal environment of flight crew members and/or cabin attendants and the performance and characteristics of that type of aircraft are realistically simulated. Standard operating procedures. Means procedures which specify a sequence of tasks and actions to ensure that procedures can be carried out in a safe, efficient and logical manner. Soporific: Means causing sleep or drowsiness. Unpredictable turbulence: Means turbulence that is not predictable and cannot be detected, that occurs in clear air, clear of clouds, usually without warning (see definition of clear air turbulence).

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Abbreviations
AC AOC ATS ATSB CAA CAAP CAR CAT CBT CCDM CRM FAA FOD FRMS FSM HF HIV HSE IATA ICAO ISC LOFT LOSA NIHL OC PA PIC PPE PSR REM SMS SOPs Advisory Circular Air Operators Certificate Air Traffic Service Australian Transport Safety Bureau Civil Aviation Authority of New Zealand Civil Aviation Advisory Publication Civil Aviation Regulations Clear Air Turbulence Competency Based Training Cabin Crew Development Manager Crew Resource Management (United States) Federal Aviation Administration Foreign Object Debris Fatigue Risk Management System Flight Service Manager Human Factors Human Immunodeficiency Virus Health and Safety in Employment International Air Transport Association International Civil Aviation Organization In-flight Service Coordinator Line Oriented Flight Training Line Oriented Safety Audit Noise Induced Hearing Loss Operator Certificate Public Address (system) Pilot in Command Personal Protective Equipment Purser Rapid Eye Movement Safety Management System Standard Operating Procedures

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Section One General Duties under the Health and Safety in Employment Act 1992
All people who work on board aircraft must ensure that they are working in a safe manner and that no action or inaction by them, while at work, causes harm to any other person. 1.1 General Duties of Employers Air operators must take all practicable steps to ensure the safety of cabin crew and flight crew while at work and in particular: 1. Protect the health and safety of every crew member while at work. 2. Regularly go through a process of systematically identifying hazards. 3. Maintain a register of hazards. 4. Make sure any hazards are eliminated, isolated or minimised. 5. Ensure that every crew member is made aware of every known or foreseeable health and safety hazard in the areas where he or she will work. 6. Provide suitable protective equipment and clothing to crew members, and train crew members in the use of that equipment and clothing. 7. Provide safety information to crew members, including involving them in hazard identification. 8. Ensure crew members receive information, instruction, training and supervision necessary to ensure the employees health and safety at work. 9. Monitor crew members to determine if their work is causing them health problems. 10. Encourage crew member participation and provide ways for them to contribute to health and safety. Health and safety committee members should receive training in occupational health and safety. 11. Investigate, record and report, in the prescribed manner, all serious harm accidents, occupational disease or hazardous occurrences. 12. Provide and maintain a safe working environment. 13. Provide and maintain facilities for the safety and health of crew members while they are at work. 14. Ensure that plant used by any crew member at work is arranged, designed, made and maintained so that it is safe for the crew member to use. 15. Ensure that while at work, crew members are not exposed to hazards arising from the arrangement, disposal, manipulation, organisation, processing, storage, transport, working, or use of other things in their place of work, or near their place of work and under the operators control.

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16. Develop procedures for dealing with emergencies that may arise while crew members are at work. If you are a principal to a contract, you will need to comply with the Contractor Management section of this guideline. 1.2 Hazard Management Including Risk Management Section 7 of the Act provides that employers shall ensure that there are in place effective methods for: (a) systematically identifying existing hazards to employees at work; and (b) systematically identifying (if possible before, and otherwise as they arise) new hazards to employees at work; and (c) regularly assessing each hazard to determine whether or not it is a significant hazard. The Act is designed to promote the management of health and safety issues in workplaces and requires employers to take all practicable steps to eliminate, isolate or minimise workplace hazards. Obligations are also placed on selfemployed persons, principals and on persons who control places of work. A hazard may be an actual or potential cause of harm. It can also be a situation where a persons behaviour may be an actual source of harm to themselves or others. It can be physical or biological, including temporary conditions that affect a persons behaviour, such as fatigue, shock, alcohol or drugs, and it can arise or be caused within or outside a place of work. Effective methods must be in place for systematically identifying hazards to cabin and flight crew members at work; this includes systematically identifying new hazards and regularly assessing each identified hazard and determining whether or not it is significant. The primary reason for identifying hazards and assessing the risk to cabin and flight crew is to inform the employer of the hazard and risk, to prevent an accident or incident which could lead to injuries, ill health or fatalities. Risk assessments are also helpful in determining whether hazard controls meet the requirements of the Act. Risk assessments are a key part of good occupational health and safety management. The aim is to proactively identify hazards on board aircraft to determine what risks are associated with them; as a guide operators should: (a) Systematically identify each hazard that can arise from an activity, location or task that the crew member undertakes. Four commonly used methods of hazard identification are: (i) Physical inspections. Walking around the place of work with a checklist. (ii) Task analysis. Looking at the tasks in each job and observing the actions of crew members, while identifying the hazards involved. (iii)Process analysis. Following the production or service delivery process from the start to the finish, identifying the hazards involved at each stage.

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(iv) Accident investigation and analysis. This is mandatory under section 7(2) of the Act. Whenever there is an accident, near miss, or an incident of harm, the employer must take all practicable steps to determine the cause and ascertain whether it was a significant hazard. This corresponds with the requirement for employers to keep a register of every accident or incident. (b) Reported hazards must be acknowledged and investigated. It is important that all employees know what hazards they are required to report. (c) Determine who or what could be harmed and how. (d) Put hazard controls in place. There is a hierarchy of hazard management controls. Sections 7 10 of the Act specify steps that an employer must take to manage significant hazards in the workplace. 1. 2. Identifying hazards as above. Assessing the hazard to evaluate whether it is a significant hazard and the likelihood and degree of injury or harm occurring to a person if they are exposed to the hazard (see section 7(c)). Controlling the hazard by taking all practicable steps to eliminate, isolate, or minimise significant hazards as appropriate (sections 8, 9, and 10). Monitoring any exposure to a hazard that has been minimised (section 10).

3. 4.

To control occupational injury and disease hazards, it is preferable they are dealt with by design or redesign, substitution, separation or administration. These controls generally eliminate, isolate or minimise hazards more reliably than personal protective equipment. Controls may reduce the significance of a hazard or the likelihood of it causing harm to crew members or others. 1.3 All Practicable Steps This term applies to general duties that must be carried out by employers, employees, self employed people, people who control places of work and principals(people that engage contractors to carry out work for them). The Act specifies that a person is required to take those steps only in respect of circumstances that the person knows or ought reasonably to know about. Where circumstances are known, or ought reasonably to be known about, then the operator is required to take all steps that are reasonably practicable. A step is practicable, if it is possible or capable of being done. Whether a step is reasonably practicable in the circumstances depends on the following factors: The nature and severity of any harm or harm that may occur; The degree of risk or probability of injury or harm occurring; How much is known about the hazard and the ways of eliminating, isolating or minimising the hazard and; The availability and costs of safeguards.
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1.4 Accident/Incident Reporting and Investigation All employers of cabin crew and flight crew must maintain a register of accidents and serious harm and must record all accidents that harmed or could have harmed these employees at work on board the aircraft. Safety reporting by flight and cabin crew should interface with other reporting and assessment systems in use by the operator to permit correlation between systems. Selfemployed persons and principals must also maintain a register of accidents and serious harm, and record all accidents. 1.5 Serious Harm Investigation and Reporting Employers, selfemployed persons and principals must notify the CAA of all occurrences of serious harm that occur to an employee at work, or as a result of a hazard the employee was exposed to at work. Serious harm must be reported as soon as possible to the CAA. Within seven days of the occurrence, the initial notification must be followed up in writing on the prescribed form of register or notification of circumstances of accident or serious harm. This includes injuries to passengers. There is a copy of this prescribed form within the CA005 form or on the CAA website under the health and safety section. The name, address and phone number for the injured person also needs to be included. 1.6 Investigation Reports If an incidence of serious harm is notified to the CAA, invariably the employer will have to provide an investigation report to the CAA HSE Unit. Investigation reports should include the following relevant information: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. An event number. Date the report was completed. Signature and job title of the person/people who completed the report. Time of day the incident / accident occurred. In flight location of incident /accident. Sector. Length of time into sector. Aircraft type and registration. Names of injured employees and their job titles. Name of injured passengers. Description of injuries sustained and any treatment including follow up medical treatment.
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12. 13. 14. 15. 16. 17. 18.

How long the crew member has been employed by the company. How many hours the crew member has worked since they arrived at work. A detailed summary of the incident /accident. Any causative actions. Any conclusions. Any recommendations Any post accident/incident actions that have been taken, and when they were taken. This could be in the form of an action plan /corrective action plan.

The HSE Unit will assign a work request number to this notification, eg, 09/HSRI/100, and may then conduct its own investigation and will call for any additional information necessary to complete the investigation or to close this work request. 1.7 Employee Responsibilities Cabin and flight crew are persons who are employed or engaged to work onboard an aircraft where the aircraft is a place of work. As employees they can expect that their employer will make sure that the aircraft is safe. As crew members they also have responsibilities. They must: 1. Make sure that they take all practicable steps to ensure their own safety while at work. For e.g. tie loose clothing and long hair and remove dangling accessories, rings or other jewellery which could become entangled with a machine, moving parts of machinery or have contact with energized electrical equipment. Make sure they dont do anything that harms anyone else or fail to take any action that could result in harm to others. Use the protective clothing that they or their employer provide and abide by their employers footwear code. Not do work which could result in serious harm. Immediately report injuries, accidents and incidents and work related ill health, or other hazardous occurrences. Take action to make unsafe work safe or, if they cant, tell their manager. Know about and follow their employers health and safety policies and procedures. Work with their employer in the monitoring of hazards and their health. Report hazards and safety concerns as they become aware of them.

2. 3. 4. 5. 6. 7. 8. 9.

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1.8 Hazards/Incidents Crew Members Should Report Cabin and flight crew need to know what hazards and incidents they are required to report to their employer. Below are some commonly reported hazards, and incidents. These are examples only, any event or situation with the potential to cause harm/serious harm, or affect the level of safety should be reported. 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. Dangerous goods in the cabin. Crew or passenger incapacitation. Crew or passenger serious illness or serious harm injury. Galley issues or galley/cabin equipment that needs maintenance. Carts that they have identified for maintenance including the cart model and serial number. Aggressive, violent, or intoxicated passengers. The presence of fire/smoke/fumes are present in the passenger compartment. Activation of toilet smoke detectors. Failure of passenger(s) to abide with the instructions of the flight crew. Failure to arm a door. When significant turbulence is encountered. When there is a decompression of the aircraft. When a slide is inadvertently deployed. Bird strike or foreign object debris (FOD). An engine has to be shut down in flight. Defective or inadequate safety equipment or procedures. Communications failure or impairment. Significant handling difficulties are experienced. A runway or taxiway incursion occurs. Aircraft lands with reserve fuel or less remaining. Any safety related event that is significant to crew or has safety implications.

1.9 Duties of Employees Employees also have duties under the Act. Section 19 of the Act provides that employees have to practicable steps to ensure that no action or inaction by them harms another person. Cabin and flight crew should not undertake work which is unsafe, or involves unsafe work practices and/or not to omit do something that can cause harm to another person.
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Where employees become aware of an unsafe work situation or practice they should make it safe, if they cannot make it safe, they should inform their ISM, ISC, and PIC as appropriate. 1.10 Duties of Employers to People Who Are Not Employees Employers have a duty under the Act to people who are not their employees. This includes passengers and any other people who could be affected by the employers work activity (eg bystander). Employers must take all practicable steps to ensure that no actions or inactions of their employees while they are at work causes harm to any other person. 1.11 Duties of Principals The Act places a duty on a principal to a contract to take all practicable steps to ensure that contractors, subcontractors and their employees are not harmed while undertaking any work under a contract. This duty is set out in Section 18. An individual or company who engages any person (other than as an employee) to do any work for gain or reward is a principal in terms of the Act. In providing for health and safety to contractors, the principal might treat the contractor as an employee for health and safety purposes. In other situations, the principal might require the contractor to organise their own health and safety. A contractor is a person who is in business in their own right and is engaged to do any work for gain or reward other than as an employee, who comes into a workplace to carry out specific tasks. The term contractor can include: 1. A person engaged to carry out the normal business operations of a company, such as a pilot working on a short term contract, or a maintenance provider who comes into an employers workplace to do their work. A person engaged to carry out a task that is not a normal business operation such as an electrician repairing a power outlet. A labour only contractor provided by a labour hire company is considered to be an employee of the labour hire company who holds the contract to provide the labour.

2. 3.

A principal or contractor may also be an employer and if so, they will have the duties of an employer.

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Section Two Cabin Environment


2.1 Manual Handling Manual handling can be a contributory factor to the onset of discomfort, pain and injury. Rarely will just the act of handling an object be solely responsible for any discomfort, pain or injury, but when combined with other factors it becomes a problem. For example, carrying out manual handling tasks without sufficient breaks or using poor body positions and in a poor state of health poses an increased risk. The Act requires employers to provide safe places of work and this includes taking steps to ensure manual handling tasks are carried out safely. Employers should identify all of the contributing factors to hazardous manual handling tasks, assess their significance, provide controls where they are needed and evaluate the effectiveness of those controls. Factors that work together in varying proportions depend on each crew members task. They include:
Contributing factors:

1. 2.

Individual factors. Things a person can change (e.g. diet, fitness, sleep) and things they cannot change, (e.g. age, height, gender). Psychosocial factors. How a person thinks, and what they believe about things, mores and social habits, circumstances at home, or at work (e.g. financial concerns, relationship issues, how they cope with discomfort or pain). Work organisation. How work is arranged, delegated and carried out, ie, hours of work, when breaks are taken, peaks/troughs in workload, and changes in work tasks. Crew who work alone or in isolation may be at an increased risk of harm because of a lack of assistance with hazardous manual handling tasks. Workplace layout and physical demands. The way the workplace is set up and the working positions crew members adopt e.g. awkward postures, reaching up to remove standard/stowage units). (i) (ii) (iii) (iv) (v) Retrieval and storage of items into carts and within the bins in carts, such as plastic bins. arming and disarming aircraft doors. putting hand luggage under passengers seats assisting passengers who have reduced mobility. repetitive movements.

3.

4.

5.

Loads and forceful movements. The objects being handled and the forces being applied, e.g. pushing a fully laden meal/drink cart. (i) (ii) Manoeuvring food and beverage carts; in particular during episodes of turbulence. stowage of carts in the galley.

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(iii) (iv) (v) (vi) (vii) (viii) (ix) 6.

lifting standard units in the galley. lifting passenger hand luggage into overhead lockers. handling or reaching away from the body; for example, carrying passengers overweight hand luggage inside the aircraft cabin. lifting/carrying crew members luggage. putting hand luggage under passengers seats. assisting passengers who have reduced mobility including moving the body of an ill or deceased person. carrying a float of coins for on board sales of food and beverages.

Repetitiveness or monotony. The amount a task changes over time e.g. repetition of tasks such as prolonged holding of stooped positions like reaching into carts and repeated arm action, when pouring drinks. (i) (ii) Encourage employees to stand up and stretch if doing tasks which involve awkward postures. regularly rotate tasks that require awkward, repetitive or sustained postures. Encourage crew to help each other by agreeing to regularly rotate tasks.

7.

Environmental issues. Where the work takes place and the conditions a person works in (e.g. in a confined space such as the galley). Employers should involve crew in the adaption of existing workplace areas or whilst developing specifications of new designs.

It is important to understand that it is a combination of the factors, rather than any one particular factor in isolation that may trigger discomfort, pain and injury. Employers must have systematic and effective methods in place to identify existing hazards, identify new hazards and assess hazards to determine whether they are significant or not. Where there is a significant hazard the employer must take all practicable steps to control it. Employees must take all practicable steps to ensure their own safety and that of others while at work. 2.2 Handling of Cabin Baggage
Employer Responsibilities

Employers should have effective systems in place, such as a cabin baggage control programme, to minimise the risk of cabin baggage as a hazard. These systems should facilitate security checks at the airport as well as minimise the likelihood of injuries caused by luggage falling from overhead lockers. It will also help to ensure that the aircraft cabin remains clutter - free, enabling easier movement throughout the cabin for cabin crew, passengers, and when dealing with medical emergencies. Cabin baggage taken on board aircraft, should not exceed the air operators requirements for weight and number of items. Checks should be carried out on cabin baggage at check-in and

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prior to boarding, and baggage that exceeds the allowed limits should be removed and stored in the aircraft cargo compartment.
Employee Responsibilities

Cabin crew should ensure that all baggage taken into the passenger cabin is adequately and securely stowed. Cabin crew should avoid lifting passengers cabin baggage into overhead lockers and encourage passengers to stow their own baggage. If a passenger asks for assistance, the crew member should assess the weight of the item and then if necessary, ask the passenger or another crew member to assist with lifting the item into the locker. Overhead lockers should not be forced shut to accommodate large or awkward shaped baggage. All baggage should be of a size that can fit into the overhead lockers or under the seat in front of the passenger. Heavy baggage not detected at check-in, and found to be too heavy to lift into the overhead lockers, should be placed under a passengers seat or removed to the aircraft hold. Cabin baggage stowed during boarding should not interfere with the direct and easy access to, and use of, emergency equipment. All personal belongings should be restrained in approved stowage areas before the aircraft door is closed. Approved stowage areas include: 1. Overhead bins. Each bin should be totally enclosed and have a door that latches closed. It is recommended that a maximum weight limit be noted on bins, this limit should not be exceeded. Under seat stowage. The space beneath the passenger seat may be utilised as stowage provided a restraint bar is fitted as part of the seat. Baggage should fit under the seat securely and should not impede exit from either row. All other stowage should be totally enclosed and have signage with the maximum allowable limit.

2.

3.

All crew and passenger cabin baggage should be stowed correctly. Place baggage in a locker or under a passenger seat in such a way that it will not slide forward under crash impact or hinder evacuation in the event of an emergency. No baggage should be placed on top of an ottoman. Small items can be placed inside of an ottoman. Crew rest and toilet compartments shall not be used to stow baggage. Exits, aisles and the space forward and aft of the bulkheads should be clear of baggage or obstructions. If seats adjacent to over - wing exits are unoccupied, baggage must not be stowed under the seats in front of the unoccupied seats. Decompression grills must be kept clear of obstructions at all times. Cabin baggage includes the following: Clothing or garments. Tote bags. Suitcases (hard and soft). Laptop computers. Briefcases.
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Shopping bags. Papoose like baby carriers with hard, nonfolding frames. Additional items permitted in the cabin include: Handbags of reasonable size. Overcoat or jacket/wrap e.g. pashmina. Umbrella. Small camera or camera pack. Small music player (CD Cassette, etc) with headset. Reading material. Assistance devices for people with disabilities.
Recommendations

1.

At check in, all passenger baggage (including hand baggage) should be checked for weight, size and shape. Then, an option for operators could be to label this hand luggage at check in with a unique identifier that is dated/colour coded so passengers do not attempt to bring additional undisclosed luggage on board the aircraft. Cabin baggage size and weight scales should be located just before passengers go through security, random spot checks could then be completed and bags returned to check - in (time permitting). Passengers who exceed the cabin baggage weight limit or number of items should be asked to return to the final check - in and have the luggage removed to the hold. Where this is not practicable (e.g. international flights), have the luggage moved to the hold by ground staff. The luggage should be stowed correctly, and the passenger informed about the air operators policy for cabin baggage. Individual air operator policy about stated maximum weight, size and number of cabin baggage items allowed should be clearly stated and strictly applied to minimise manual handling risks. Weight, size and shape requirements should equally apply to crew members baggage.

2.

3.

4.

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2.3 Turbulence Turbulence is the result of atmospheric or environmental effects. It accounts for a substantial amount of injuries reported each year. Turbulence can occur at any time, and any altitude and be expected or sudden and unexpected CAT. Preventing injuries during turbulence requires teamwork and personal responsibility from each individual crew member. Flight crew and cabin crew must keep each other informed of turbulent conditions and take appropriate action to minimise the risk of injuries. The safety of cabin crew is paramount during turbulent conditions because if cabin crew are injured, passengers needs and emergency procedures may not be met.

Reproduced from Flight Safety Australia, May - June 2006

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Hazards Associated with Turbulence

Physical Burns/scalds Slips, trips and falls Barotrauma to the ears Injuries Sprains and strains Bruising Fractures Biological Vomiting Blood and body fluids Psychological Distress, anxiety and panic Challenging behaviour
Turbulence Guidance

(Reproduced with permission of Flight Safety Australia, May June 2006) Standard terminology definitions section Duration Occasional Less than 1/3 of the time Intermittent 1/3 to 2/3 of the time Continuous More than 2/3 of the time Intensity Light chop Slight, rapid and rhythmic bumpiness without major changes in altitude or attitude. Light turbulence Slight, erratic changes in altitude and/or attitude. Occupants may feel a slight strain against seat belts. Unsecured objects may be displaced slightly. Food service may be conducted and little or no difficulty is encountered in walking. Moderate chop Rapid bumps without appreciable changes in aircraft altitude or attitude. Moderate turbulence Changes in altitude and/or attitude occur but the aircraft remains in positive control. It usually causes variations in indicated airspeed. Occupants feel definite strain against seat belts. Unsecured objects are dislodged. Food service and walking are difficult.

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Severe turbulence Large, abrupt changes in altitude and/or attitude. Large variations in indicated airspeed. Aircraft may be momentarily out of control. Occupants are forced violently against seat belts. Unsecured objects are tossed about. Food service and walking are impossible. Extreme turbulence Aircraft is violently tossed about and is practically impossible to control. May cause structural damage. Causes of turbulence Thunderstorms Turbulence associated with thunderstorms or cumulonimbus clouds. A cumulonimbus cloud with hanging protuberances is usually indicative of severe turbulence in their vicinity. Clear air turbulence Turbulence above 15,000ft not normally associated with cumuliform cloud. Often occurs entering or leaving jet streams or flying near them. Mountain wave Turbulence resulting from air being blown over a mountain range or a sharp bluff causing a series of updrafts and downdrafts. General operating procedures If significant turbulence is expected before the flight departs, the pre-flight briefing to the lead flight attendant must include turbulence considerations. The briefing should include: What the captain wants the cabin crew to do when turbulence is expected. Intensity of turbulence expected. Method of communicating to the cabin crew the onset or worsening of turbulence (cabin interphone or PA). Phraseology for the cabin crew to communicate the severity of turbulence. Expected duration and how an all clear will be communicated. Use of a positive signal for when cabin crew may commence their duties after take off, and when they should be seated and secured prior to landing. If flight into turbulence is unavoidable: Passengers should be informed of routine turbulence via the PA system. Do not rely on the seat belt sign alone. Cabin crew should be informed of routine turbulence via interphone. If the cabin crew experience uncomfortable turbulence without notice from the flight crew, they should take their seats and inform the flight crew. All service items must be properly stowed and secured when not in use. Flight crew encountering turbulence should: Inform Air Traffic Service (ATS) of turbulence, and request information from previous flights through the area at check in with a new controller. Inform the air operator so that the following flights will be aware of the flight conditions or can plan another route. Exchange information with other aircraft operating in the area on a common frequency.

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When advised of turbulent conditions Prior to departure, seek alternate routing or flight levels to avoid the affected areas, or delay departure until conditions improve. Change routing or flight levels en route. Slow to the manufacturers recommended turbulence penetration speed. Prior to descent, seek alternate routing to avoid the affected areas or, if severity dictates, hold or divert to alternate. Avoid any significant convective activity en route by at least 20nm. When sufficient warning exists for passengers to return to their seats and for the cabin crew to perform their duties: The PIC should turn on the seat belt signs and make a PA announcement to the effect that cabin crew should stow their service items and take their seats. Passengers should remain seated until the area of turbulence has passed and the PIC clears them to move about the cabin. Cabin crew should stow all applicable service items, perform cabin compliance check, and secure themselves in their jump seats. Lead flight attendant informs PIC of the completion of these duties. When conditions improve, PIC uses the PA system to advise the cabin crew that they may resume their duties and that passengers may or may not move about the cabin. If there is sudden, unexpected turbulence requiring immediate action to protect cabin crew and passengers: The PIC should turn on the seat belt signs and make a PA announcement to the effect that cabin crew should immediately take their seats. Passengers should remain seated until the area of turbulence has passed and the PIC clears them to move about the cabin. Cabin crew should take the first available seat and secure themselves. No compliance checks are to be performed and service items should be secured only if they cause no delay to securing a person in a seat. When conditions improve, PIC should use the PA system to advise the cabin crew that they may resume their duties and that passengers may or may not move about the cabin.

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Design Safeguards

When an aircraft encounters unanticipated turbulence there may not be time for preparation by cabin and flight crew or passengers. In this situation, measures most likely to prevent or mitigate injuries caused by turbulence involve aircraft design. Effective aircraft design features promote the following: Interior restraints and overhead bin doors to prevent equipment failures during turbulence. Cabin structures with a minimum of hard or angular surfaces, corners, or protrusions. Emergency handholds, such as handles, bars, or interior wall cut outs in the cabin, galley, and lavatories for use by cabin crew and passengers who are not seated with seat belts fastened. Handrails and handgrips under overhead compartments in the cabin. Horizontal and vertical grab bars on the counters and stowage compartments in galleys. In configurations where seats are distributed with a large pitch and the seat backs can be reclined to an almost flat position, supplemental handholds beside the seats or partitions around the seats to provide a handhold if the seat is fully reclined. Handholds can be installed outside the lavatories on the bulkhead walls for use by passengers who may be standing outside the lavatory at the onset of a turbulence encounter.
Employer Responsibilities

Before commencing a flight, the employer must have a process that directs the PIC to ensure that cabin and flight crew are familiar with all the necessary meteorological information appropriate for the intended flight. Procedures should be in place to deal with unexpected clear air turbulence and expected turbulence, and the consequences of turbulence. Turbulence procedures should address turbulence intensity criteria which cover at least three of the four turbulence criteria, including light, moderate, severe and extreme turbulence. Actions to be taken with each degree of turbulence should be specified. It is also helpful to include an aircraft and cabin reaction for each criterion. Training should emphasise effective two-way communication between the flight deck and cabin, to ensure the safety of passengers and crew members. Turbulence severity can vary throughout the aircraft and this may not be apparent to the flight crew, who should be updated by cabin crew members. Effective team performance can be promoted by using standard terminology so that the meaning and intent of what people say and do is never in doubt. Development and review of standard operating procedures so that all cabin and flight crew know what to expect and what to do during a turbulence encounter.

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Employee Responsibilities

Ensure effective pre-flight briefings are given regarding the potential for turbulence encounters during each sector. Information flight crew receive from pre flight weather briefings and from other pilots about forecasts of turbulence should be passed on to cabin crew members. Cabin crew should pay particular attention to turbulence forecasts in the pre-departure briefing. Flight crew should promptly and clearly communicate turbulence advisories which give explicit directions to cabin crew and passengers. Advisories can include directions to be seated with seat belts fastened, and to secure cabin service equipment. Following the operators turbulence procedures should ensure that cabin crew effectively communicate directions to passengers to be seated with seat belts fastened as appropriate. All passengers, including infants, should be secured with appropriate belts at all times when the seat belt signs are illuminated. Bassinet covers are to be fitted or infants secured on adults laps. Toilets should be vacated. Galley and service equipment, such as carts should be secured. All loose items in the cabin and galley should be stowed or locked away. Cabin crew should occupy the designated crew seats and fasten their seat and shoulder belts, or in severe or unexpected turbulence if the PIC commands them to sit down immediately, they should sit in the nearest available seat with seat belts securely fastened. Cabin crew should remain seated until the all clear signal form the flight crew.
Recommendations

1. 2. 3. 4.

Promote seat belt use and compliance with the fasten seat belt sign. Back up seat belt signs with PA announcements. Flight crew should be prompt in advising cabin when it is safe to move around the aircraft again with clear, concise communication. The practice of allowing children to hand out sweets towards the end of a flight should be prohibited. Turbulence can be sudden and unexpected and children should not be placed at risk.

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2.4 Slips, Trips and Falls Many incidents and accidents involving slips, trips and falls occur each year. Inflight turbulence, particularly unexpected turbulence, obstacles in aisles, passenger actions and missing air stairs have all caused serious harm injuries. Cabin crew are frequently busy with service or safety-related duties while the seat belt sign is on; because of this, their risk of injury from turbulence is high. Hazards leading to slips, trips, and falls include: Sudden braking/manoeuvring of the aircraft Items such as plastic bags, plastic lids, audio headsets and cords, covers from meal trays, documents and other discarded objects Inappropriate footwear Liquids or ice spills on the galley floor Passengers opening toilet doors Passenger urine on toilet floors Passenger vomiting or collapse due to ill - health or motion sickness Providing service when lighting is low or at night Falling through open aircraft door Unexpected turbulence The steep angle of the aircraft and the cabin floor during some climbs and descents.
Employer Responsibilities

Education should be provided to help crew identify and manage slip, trip, and fall hazards. Employers should have a safety requirement for appropriate non - slip shoes with a recommended heal height, and ensure that appropriate footwear is worn. Cabin service should be designed to avoid the use of carts and trolleys while the aircraft is flying at a steep angle. Employers should have procedures in place to ensure that cleaners effectively dry all floors after cleaning to prevent falls for cabin crew members who enter an aircraft immediately after cleaning. This is a significant issue due to the pressure of quick turn-arounds. Civil Aviation Rule 91.205 A key employee responsibility is compliance with Civil Aviation Rule 91.205 which requires that procedures are in place to ensure that all cabin crew members are seated with a seat belt or safety harness fastened during take off and landing and when the PIC directs, unless they are required to perform duties in connection with the operation of the aircraft or would be unable to perform their duties with the shoulder harness fastened.

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Employee Responsibilities

Cabin crew should ensure that all doors and aisles are kept clear at all times and they should regularly monitor for potential hazards that may result in accidents. All seating must be free of items that could pose a trip hazard, or become airborne during a heavy landing. All spills in the galley should be cleaned up immediately. Cabin crew should be able to reach safety equipment and operate overhead compartments in the aircraft. Cabin crew should face towards overhead bins and use both hands when closing bins to maximise security of footing.
Recommendations

1. 2. 3. 4.

Turn galley lighting up high during meal service times. Use a torch if providing cabin service when lighting is low or at night. When walking backwards with carts, ensure the crew member walking forward is keeping alert for any obstacles. Replace any dangling seat belts or cabin baggage that is protruding into the aisles as part of cabin checks.

2.5 Air Quality Onboard Aircraft

Air quality is affected by recirculation of air, air intake from outside the aircraft, and other sources of possible contamination. Contamination may take place due to activities outside the aircraft before or after take - off, lubricants and oils in the engine; accidents and incidents inside the pressurised cabin; or from the hold. Several potential hazards, some of which have been implicated with significant sickness, can affect air quality, and certain types of aircraft have been identified as posing an increased risk, specifically where engine bleed air is used to supplement cabin air. Employees should be protected from the inhalation of any contaminant in workplace air. Where practicable, dust, fumes, steam or other impurities which arise as a result of any process, or in the course of the work, should be removed at the point of origin. Poor quality cabin air includes air that is affected by: Unpleasant odours. Inadequate circulation of fresh air. Smoke or fumes. Chemical contamination or biological contamination.
Employer Responsibilities

The employer has a responsibility to provide air that is safe to breathe for cabin and flight crew and passengers. Under normal operating conditions and in the event of any failures, ventilation systems should be designed to provide a sufficient amount of uncontaminated air to enable crew members to perform their duties without undue discomfort or fatigue. The systems should also provide
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reasonable passenger comfort. (This implies safety in design, filtration of air, and vigilance against failure of systems). All crew and passenger compartment air must be free from harmful or hazardous concentrations of chemicals, biological gases or vapours. Accordingly, the design, maintenance, and monitoring of the work environment needs to be considered. Employers must ensure that regular and appropriate maintenance and cleaning of filters and ducts is undertaken to aid air quality in the cabin. During periods of peak activity aircraft may be on the ground for a minimal time, but this should not be allowed to cause delays to the cleaning and maintenance programme. Maintenance programmes should incorporate a process to prevent leaks, particularly in hydraulic fluid lines, that cause smoke and odours in the cabin and cockpit. Employers must ensure that during failures or malfunctioning of the ventilating, heating, pressurisation or other systems and equipment, the safety of crew and passengers remains paramount. Aircraft ventilation systems have an optimal function during flight, their airflow is decreased during takeoff and landing. When the aircraft is on the ground, ventilation and airflow may be slight or nonexistent. Air operators must ensure that ground delays are minimised and that, where delays occur, processes are in place to supply an adequate ventilation source.
Employee Responsibilities

Cabin and flight crew have a responsibility to report any smell, awareness or suspicion of poor air quality, physical discomfort, or sickness perceived to be attributable to poor air quality, to their Manager. Complaints about air quality from passengers should also be recorded and passed on to Managers.
Recommendations

1. 2.

Where ground delays exceed more than 30 minutes, procedures should be in place to ensure adequate ventilation on board the aircraft. Air operators should take care when selecting cleaning products, and ensure adequate ventilation and control of any fumes whilst cleaning is undertaken.

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2.6 Unruly or Disruptive Passengers A passenger who behaves in a violent or distressed manner can be a serious threat and a hazard to health and safety on board an aircraft for cabin and flight crew and other passengers. An unruly passenger is one whose behaviour poses a threat to the safety of flight and its passengers, crew, or property. Passenger misconduct can range from rude and boorish behaviour to physical assault. Factors that can contribute to inappropriate passenger behaviour include: Stress, e.g. fear of flying. Flight delays. Alcohol or chemical consumption (including medication). Nicotine or oxygen deprivation. Lack of physical space. Psychological perception of a lack of space. Mental or physiological distress. Unrealistic expectations of passengers with a demanding or intolerant personality. Frustrated needs, e.g. passengers denied carry-on baggage or an upgrade.

Passengers denied an upgrade. Substance abuse. Stimulants, depressants and drugs can all have an effect on emotions and behaviour. Restless, agitated, abusive, violent and even psychotic behaviour may result from overdoses of stimulants while overdoses of depressive drugs may lead to loss of consciousness. Drugs can also have complex interactions when taken with alcohol.
Passenger Psychiatric Illness

Signs and symptoms and hazards associated with passenger psychiatric illness include: Changes in behaviour, violent and aggressive behaviour. Impaired cognition and ability to think. Psychiatric disturbance. Mood affected, anxious and distressed behaviour.
Violent Passengers/Passenger Restraint

Hazards associated with violent passengers and passenger restraint include: Physical injury. Psychological injury.

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Signs and symptoms of passengers under the influence of drugs and alcohol include Altered consciousness / reality testing. Behavioural problems.
Employer Responsibilities

Employers must have a zero tolerance for physical assaults against cabin and flight crew. Employers must establish and maintain training programmes to ensure that cabin and flight crew act in the most appropriate manner to minimise the consequences of unruly and disruptive behaviour incidents. Cabin crew and flight crew should be trained to recognise the early warning signs of potentially disruptive behaviour, and should be trained in appropriate response procedures. The minimum contents of this training programme must include the following: How to determine the seriousness of the event Crew communication and coordination Appropriate self - defence responses The use of any authorised non - lethal protective devices assigned to crew members. An understanding of human behaviour to enable crew members to cope with passengers responses Live situational training exercises covering various threat scenarios Flight deck procedures to protect the aeroplane Employers must have clear policies in place directing crew in how to deal with disruptive behaviour, especially in its early stage, to prevent it escalating. The procedures should address the several levels of categories of passenger misconduct, providing clear directions for each level. Cabin and flight crew who come into contact with disruptive passengers, must have been trained in the necessary skills to manage these passenger conflict situations. Joint training of cabin crew and flight crew is recommended. Cabin and flight crew must be trained so that they understand the importance of informing other operational areas of the situation, to enable them to deal effectively with the passenger(s). They should also be trained in how to advise an enforcement agency about the situation.

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Employee Responsibilities

During the flight, the PIC must be informed whenever a potential unruly passenger is on board. Flight crew should avoid dealing directly with passengers as they are needed to fly the aeroplane. If all efforts to contain the unruly passenger fail and a threat to safety is identified, immediately advise the PIC who shall evaluate the situation and decide on a course of action. If the PIC has reasonable grounds to believe that a person has committed or is about to commit an offence or act which may jeopardize the safety of the aircraft, the PIC might impose certain reasonable measures upon the person, including restraint, to protect the safety of the aircraft, its passengers, and cargo. Accurate and updated reports and statistics of incidents must be maintained to continually monitor the types of incidents that occur and to identify potential training needs. All incidents of disruptive, unruly and violent passengers must be reported to the Civil Aviation Authority of New Zealand on a CA005 Occurrence Report by the PIC. Any serious harm injuries should be reported to the CAA HSE Unit.
Recommendations

1. 2.

Employers should ensure that cabin and flight crew are trained in appropriate responses for the situations they encounter, so that they do not escalate the situation. To minimise customer frustration, air operators should ensure that passengers are regularly updated during delays and that crew members are not giving conflicting messages to passengers.

2.7 Dangerous Goods The carriage of dangerous goods is regulated by Part 92 of the Civil Aviation Rules. This Part requires operators to comply with Annex 18 to the Convention on International Civil Aviation and with the ICAO Technical Instructions for Safe Transport of Dangerous Goods by Air (Doc 9284). The International Air Transport Association (IATA) produces the Dangerous Goods Regulations which are used by industry to comply with the ICAO Technical Instructions. Air operators have a number of responsibilities regarding dangerous goods. These responsibilities are also important to those air operators health and safety obligations under the Act.
Information to PIC

Under Rule 92.173 an operator is required to provide the PIC with written information on any dangerous good to be carried onboard the aircraft. They are also required to provide the PIC with information for use in any emergency response as a result of the dangerous goods being carried.

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Information to Employees

Under Part 92.175 operators are required to provide information to their employees (and handling agents) to enable them to carry out their responsibilities with regard to the transport of dangerous goods. This includes: 1. 2. Instructions on action to be taken in emergencies arising involving the dangerous goods; and Such other information as specified in the Technical Instructions.

Additionally, ICAO Annex 6, Appendix 2 also requires that information and instructions on the carriage of dangerous goods, including action to be taken in the event of an emergency be included in the Operations Manual. Section 19 of the Act requires that employees take all practicable steps to ensure their safety at work and that no action or inaction causes harm to another person. If dangerous goods are found onboard an aircraft, cabin and flight crew should immediately take action to ensure their own safety and the safety of passengers. In general, dangerous goods shall not be carried in an aircraft cabin occupied by passengers or on the flight deck of an aircraft. However, there are some exemptions if the items are for personal care, medical needs, sporting equipment, and items used to support physically disabled passengers. Depending on the nature of the dangerous goods, these may be carried either on the passenger, in cabin baggage, or in checked in baggage. A full list of exempted items is contained in the IATA Dangerous Goods Regulations. Many common items used every day in the home or workplace may seem harmless, but when transported by air they can be very dangerous. During flight, variations in temperature and pressure can cause items to leak, generate toxic fumes, or start a fire. Sometimes dangerous goods are carried into the cabin of an aircraft by passengers who are unaware of or, deliberately ignore, the requirements of the Technical Instructions concerning passengers and their baggage. It is also possible that an item to which the passenger is legitimately entitled e.g. an item for medical purposes may cause an incident. Spillage or leakage of dangerous goods can cause smoke and fumes or even fire, (accidental or spontaneous combustion), and it is possible that dangerous goods loaded into the hold of the aircraft could be affected by smoke or fire and will exacerbate the problem. Crew members need to be aware of the following items which can be extremely dangerous: Explosives signal flares, fireworks, sparklers, ammunition, and gun powder. Compressed gasses aerosols, diving tanks, oxygen bottles, LPG cylinders. Flammable liquids or solids solvents, fuel, and oil based paints, lighter fluid, matches. Household items bleaching powders, drain cleaners, pool chlorine, disinfectants, and fibreglass repair kits. Other hazardous materials dry ice, petrol - powered equipment, poisons, liquid filled batteries, mercury, mace, and pepper spray.

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A list of hidden dangerous goods is also contained in the IATA Dangerous Goods Regulations.
Examples of Dangerous Goods Incidents

A container of nail polish remover taken on board to re-paint fingernails during flight caused respiratory discomfort to some passengers and crew. Lithium batteries from a DVD player that caught fire. Hotel match books were put into an overhead locker during flight, where they ignited causing a fire. Mercury was found pooled in an aircraft cargo hold.
Employer Responsibilities

Air operators should have a Dangerous Goods policy in place. A cabin crew procedure/checklist for suspected dangerous goods and dangerous goods incidents in the passenger cabin during flight should be available on board aircraft and include the following areas: Initial action. Actions in case of fire. Action in case of spillage or leakage. Emergency response drills. After landing actions. Cabin and flight crew members must receive training in dangerous goods incidents. This training should include how to complete a cabin crew procedure/checklist for suspected dangerous goods and dangerous goods incidents in the passenger cabin during flight. Flight crew minimum requirements for dangerous goods training include the following: General philosophy. Limitations. List of dangerous goods. Labelling and marking. Recognition of undeclared dangerous goods. Storage and labelling procedures. Pilots notification. Provisions for passengers and crew. Emergency procedures.

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Cabin crew minimum requirements for dangerous goods training include the following: General philosophy. Limitations. Labelling and marking. Recognition of undeclared dangerous goods. Provisions for passengers and crew. Emergency procedures. The employer must also notify the CAA about dangerous goods incidents.
Employee Responsibilities

All dangerous goods incidents should be recorded and reported. Cabin crew members should report to the PIC passengers carrying suspicious items as soon as they are noticed.
Recommendations

1. 2.

Emergency procedures should include the use of spill kits and personal protective equipment and clothing. Cabin crew should be aware that some hazardous/dangerous goods items which passengers attempt to bring on board are not labelled as dangerous goods and may not appear to be dangerous goods at a first glance.

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Section Three Galley Operation and Service Provision


3.1 Food and Beverage Handling, and In-Flight Equipment Hazards associated with food handling include: Lifting of overhead storage units. Protruding metal from ovens may cause lacerations. Bending and stretching to get items from the bottom of carts and out of drawers or boxes in the carts, and galley storage. Burns and scalds. Infection from used food/drink utensils. Frequently used items should be easy to manipulate and placed in areas that do not require frequent overhead lifting or bending. Where possible, tasks should be planned to avoid twisting, turning and bending of the trunk. Working heights that are too low or high will require crew members to adopt undesirable postures. The further away from the body the load is carried, the greater the potential for harm e.g. standard stowage units stored above shoulder height in galleys. 3.2 Food and Beverage Carts/Trolleys Fully laden food and beverage carts are heavy items and mobile. These must be handled with care. Crew members must consider the potential for injuries from moving carts during turbulence and during climb and descent because of the steeper angle of the aircraft and the cabin floor. Hazards associated with food and beverage carts and their stowage and maintenance include Unexpected turbulence clear air turbulence. Failure to apply cart brakes fully. Inappropriate or inadequate stowage of food and beverage carts. Failure of galley latches. Inadequate checking, repair and maintenance of food and beverage carts. 3.3 Maintenance of InFlight Equipment Maintenance programmes should be in place for ongoing inspection and preventative maintenance, repair, replacement and return to service of all inflight equipment, to minimise the risk of manual handling and other injuries. Inflight equipment includes, but is not limited to carts, trolleys, coffee pots, plastic bins in carts, and standard units.

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Procedures should be in place to identify, report, and remove faulty or defective equipment from aircraft to ensure that these items are not returned to service prior to being repaired. Regular and ongoing inspection and maintenance of carts should be in place, and all defective carts identified during service delivery should be tagged, and removed from service at the next destination. If repair and maintenance tasks are outsourced to an external organisation, the performance of these tasks should be closely monitored by the air operator to ensure that a specified standard are met. Poorly maintained plant can cause health and safety hazards including hazards associated with manual handling.
Information and Training

Unless a manual handling hazard has been eliminated, training and information for crew members will be required. Information and training should be specific to the task performed. Training cannot minimise the effects of: Unsuitable layout of the work area Unsuitable loads Repetitive tasks Poor maintenance of equipment Poorly organised work practices and systems Poor health and wellbeing High levels of stress in the workplace and at home
Employer Responsibilities

Employers should have processes in place to manage the hazards associated with food and beverage carts and their stowage and maintenance. The design of cabin service should avoid the use of carts and trolleys while the aircraft is flying at a steep angle. Cabin service design should also minimise repetitive bending actions to retrieve items from carts. Carts/trolleys should be fully functional, including brakes which should be operational. Food trays should slide easily from carts, and bins in carts should be removed from service if they have become brittle or are broken. Turbulence procedures should be in place for predicted and nonpredicted turbulence.
Employee Responsibilities

All fully laden food and beverage carts should be moved by two crew members. All re-stocking of carts should be completed in the galley. Carts must not be left unattended, unless they can be properly restrained. Always put the brakes on when the carts stationary in the cabin. Items should be cleared off the top of carts when they are restrained to avoid these items becoming dislodged and causing injuries during turbulence and sudden changes in the direction of flight.
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Do not put carts in front of toilet doors, as this can impede the exit from those areas. The responsible cabin crew member must check galley equipment to ensure it is properly restrained. Galley curtains should be open for take - off and landing. Velcro domes that hold back these curtains should be replaced as they become worn. The galley should be fully secured prior to take - off and landing. Cabin crew members should report all carts that are out of the required maintenance period. Any carts that are found in the galley and are not on the appropriate aircraft type for the cart should be reported and offloaded.
Recommendations

1. 2.

Any faulty equipment should be noted, stowed securely, and not used. The equipment should then be replaced at the next available port. Maintenance certificates/tags that are attached to carts should not be tampered with.

3.4 Burns and Scalds Burns and scalds to crew members and passengers on board aircraft have been reported. These injuries have been caused mostly by: Hot water or drink containers being tipped over by passengers and crew. Coffee - maker plunger splashes, spillages, and steam and the hot sides of pots. Hot food. Hot galley equipment such as ovens.
Hazards

Working in a confined space (galley and aisle). Turbulence. Fatigue. Stress. Equipment, ie, the inherent design of ovens, urns, food trays, coffee pots. Hot ovens and trays. Steam when opening the lids of cooked meals. Work pressure, e.g. short turn-around times. Overfilling cups at passengers request. Aircraft size, design, and type. Seat tray design. Passenger actions or inattention, e.g. knocking liquids out of hands. Inexperienced crew members.
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Employer Responsibilities

Cups that are used to serve hot liquid should be made of a material that is poor at conducting heat. Oven gloves must be made of an impervious material that does not allow seepage of hot liquid into the glove whilst still providing insulation against heat. Gloves should also fit well and enable crew to properly grip items to load carts for meal service. It is preferable to issue oven gloves to individual crew members for hygiene reasons, and to ensure they fit correctly, as hand sizes differ.
Employee Responsibilities

Care should be taken when handling coffee and tea pots. If pots without lids are loaded, ask catering to exchange or provide lids. Tea or coffee pots lids should be tight and seal well so when tipping the pot the hot liquid does not spill from the top. Do not overfill pots. When using plunger coffee makers, take care when depressing the plunger. Keep the galley clean and tidy to ensure that pots are not overcrowded, that everything has a place, and hot trays meals can be placed quickly onto a safe surface. Cabin crew must remain vigilant and focussed when working with ovens. Oven gloves must be used at all times, and care should be taken when opening the lids of cooked meals. Napkins should not be used when loading the meals from the oven to the cart.
Recommendations

1. 2.

Passengers are offered lids for hot drinks and hot drink containers are not overfilled. Cups containing hot liquids should not be more than three quarters full. On short - haul flights, drinks for pilots should be provided during turn around rather than in-flight to minimise the risk of spillage over instrumentation and electrical systems.

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Section Four Crew Health and Wellbeing


4.1 Crew Health Certain medical conditions such as angina, heart attacks, and gastrointestinal disorders can cause pilot incapacitation which can contribute to accidents. This type of incapacitation is usually detected by other crew members. The more dangerous type of incapacitation develops with a reduction in capacity resulting in partial or subtle incapacitation. This type of incapacitation can be undetected even by the person affected. It is usually caused by fatigue, stress, the use of some drugs and medicines, and certain medical conditions such as hypoglycaemia (low blood sugar). As a result of such health conditions, human performance can deteriorate in a manner that is difficult to detect but can have a direct impact on flight safety. Even though crew members are subjected to regular periodic medical examinations to ensure their continuing health, they still have a responsibility to maintain their physical fitness. Being fit can have significant positive effects on emotions, it reduces tension and anxiety and increases resistance to fatigue. Factors that are known to positively influence fitness are exercise, healthy diet and good sleep/rest management. Tobacco, alcohol, drugs, stress, fatigue and poor diet are all recognised as having damaging effects on health. Pregnancy also affects physiological changes and brings with it specific health risks to both the mother and foetus. It is compounded by the working conditions on board aircraft including a confined space, altitude, and pressure changes. These factors need to be taken into consideration by employers when assessing crew members fitness to fly. From a medical point of view, the first and last trimester of pregnancy pose the greatest risks of complications, so employers need to take cognizance of the fact that crew health could be affected by their pregnancy and make allowances for that. Crew have a responsibility to advise their employer of their pregnancy, as this may impact upon their fitness to fly. Pregnancy can affect individuals differently, so crew members need to monitor their own wellbeing.
Employer Responsibilities

There should be a clear policy concerning crew members fitness to fly during pregnancy. Radiation levels for pregnant crew members should be monitored and a radiation limit set. Flight hours and exposure to radiation need to be controlled. Once the exposure limit is met the crew member should stop flying. Procedures should be in place to manage potential complications or emergencies that could arise due to pregnancy of a crew member.
Employee Responsibilities

Section 13 of the Civil Aviation Act 1990 outlines the principal duties of a PIC. In addition, the PIC shall be responsible for ensuring that a flight is not commenced if any flight crew member is incapacitated and unable to perform their duties from causes such as injury, sickness, fatigue or the effects of alcohol or drugs.

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The flight will not be continued beyond the nearest suitable aerodrome when a flight crew members capacity to perform their functions is significantly reduced by impairment of their faculties from such causes as fatigue, sickness or lack of oxygen.
Recommendations

1. 2. 3.

Crew should limit their caffeine intake whilst flying, as this can aggravate dehydration. Crew and passengers should be encouraged to drink water, especially on long flights. Consideration and strategies for crew pregnancy should be reflected in turbulence procedures. Effort tolerance is reduced during pregnancy, so other factors that need to be taken into consideration include manual handling tasks and the potential for fatigue. Appropriate footwear should be worn that accommodates any change in balance that may occur during pregnancy.

4.

4.2 Biological Hazards to Crew Health Managing the risk of exposure to biological hazards in the workplace is an important issue covered by the Act. The Act places duties on employers and crew members to take precautions to prevent blood borne viruses and other pathogens from being transmitted through direct contact with passengers. Crew members can be exposed to disease as a consequence of performing their routine duties and tasks, and through additional responsibilities that can arise when caring for passengers who are unwell or have an injury. Crew members should be trained to minimise any risk of exposure to disease by taking the precautions necessary to protect themselves when assisting passengers. Crew members should also be aware of the procedures required for a safe clean- up of body fluids and soiled surfaces, and that transmission of biological health hazards can be via the following routes: Direct person to person Airborne Faecal oral Blood-borne
Sources of Biological Hazards

Cabin crew can come into contact with Biological hazards in the cabin environment. These could include but are not limited to the following: Blood spills, blood and organs carried on board (human and animal). Body fluids other than blood; saliva, vomit, faeces, urine, or sputum. Diseases or infection carried by crew members.

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Waste products and contaminated material, such as used cups, glasses, meal trays and eating utensils, disposal of facial tissues, used nappies and sick bags, and other personal hygiene items, and re-stocking of toilets. Rapid temperature changes as crew arrive at new locations, where they can be required to stand at the bottom of the stairs in rain and cold temperatures. These changes in temperature can make crew more susceptible to infection. Hypodermic needles and syringes. Additional hazards associated with the disposal of hypodermic needles and syringes include Hepatitis B & C. Hepatitis C is spread primarily by blood- to- blood contact. The use of hypodermic syringes to inject drugs has become the single most important risk factor. Human immunodeficiency virus. (HIV). Passengerspoor personal hygiene. Diseases or infection carried by passengers for e.g. Tuberculosis & other infectious diseases Arthropod borne diseases such as malaria and yellow fever.
Pandemics and Epidemics

The speed and efficiency of air travel and the mobile nature of the global population highlights the risk of a worldwide spread of infectious disease. An infected and infective person can easily travel from country to country in a matter of hours or days, and literally infect thousands of people including cabin and flight crew members, fellow passengers and persons in airport buildings. Of particular concern are airborne pathogens like the SARS virus and other possible pathogens such as the avian influenza virus. These viruses are spread by droplet infection, much like the common cold or flu. Air operators should have plans in place to manage any situation that may arise from pandemic infections that may affect the health and safety of their crew members.
Employer Responsibilities

Employers must manage the risk of infection from transmittable diseases. They should have procedures for dealing with infection or potentially infective substances and infective passengers and for when aircrew or passengers become unwell. Employers must ensure that sharps containers are available for disposal of needles and that there are postexposure procedures in place for the follow up of needle-stick injuries. Crew must be trained in basic hand washing, and recognition of the symptoms of passenger ill-health. Good health practices should be taught during initial training. Short term measures to help keep hands clean, such as disposable gloves, antibacterial wipes, and gel should be supplied; however, hands should still be washed with soap and water and dried thoroughly at the first opportunity. Employers must ensure that crew members are provided with suitable personal protective clothing and equipment (PPE) to protect them from any harm that may be caused by or arise

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out of a hazard. PPE must be suitable for the specific work and exposure conditions and hazards that crew members will encounter. Procedures and training should be provided for the correct use, care and maintenance of (PPE) which would include the correct method of donning, removing and disposing of contaminated (PPE). PPE includes but is not limited to: Hygienic wipes. Wet wipes should be readily available for crew as going to the toilet to wash their hands may not always be practical, particularly if there is a queue. Gloves and masks. Goggles. Sharps containers. Appropriate cleaning solutions and a place for disposal of the items used for cleaning. Biohazard bags. Mortuary kit. Warm and wet weather clothing that meets all safety requirements including high visibility requirements. Employers must ensure that crew members have access to medical treatment overseas if that is required. Clear procedures should be in place for crew to follow to obtain this treatment. Plan for the impact of an influenza pandemic upon crew members and passengers, and educate and communicate with them. Establish policies and procedures to be implemented, and allocate resources to protect crew members and passengers during an influenza pandemic.
Employee Responsibilities

Crew members must take all practicable steps to protect their health and the health of others, by following their employers policies and procedures, and by following basic hygiene practices to minimise the risk of becoming unwell. Crew members must minimise exposure to hazards when cleaning and replenishing toilets by using protective gloves and other PPE provided. Crew members must use all PPE provided to them by their employer, and follow all procedures in relation to that equipment and clothing. Crew should attempt to clean up all spills; however, in extreme conditions, the area may need to be blocked off by crew and deemed unserviceable for the remainder of the flight or until ground staff can appropriately clean the area.

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Recommendations

1.

Crew should be reminded that hand washing is an important and effective means of preventing the delivery of infectious material. e.g., nasal secretions, saliva or other body fluids that may contain viruses from soiled hands to the mouth, nose or eyes, where it can enter the body. Gloves should be worn when collecting all food, drink containers, face wipes and disposable nappies from passengers, or items that may contain biological hazards. Crew members who become ill should take the following precautions: Do not travel while ill, unless travelling locally for healthcare. Limit contact with others as much as possible can help prevent the spread of an infectious illness. If travel is essential, e.g., to seek medical care, wear a paper or gauze surgical mask to decrease the possibility of transmitting the illness to others. If illness occurs while travelling, notify their employer and request assistance to locate a healthcare provider. Advise their employer if they are concerned about possible exposure to avian influenza, and ask about all available healthcare options. Before visiting a doctor's office, clinic, or emergency room, warn the healthcare provider about possible exposure. If illness onset occurs after returning home, contact a healthcare provider. Before going to the doctor's office or emergency room, advise the medical staff of symptoms, the countries visited, and whether the employee had contact with poultry.

2. 3.

4.3 Hearing Conservation in the Workplace Aircraft are considered to be high risk environments for noise-induced hearing loss (NIHL). Noise levels vary with aircraft types and with different jobs on board and around aircraft. The effects of noise are gradual and insidious and cause damage over a period of time from months to years. All air operators and crew members need to be vigilant in the prevention and control of hearing impairment within the aviation industry. Not only will hearing loss impact upon a persons ability to perform their job, it also impacts upon them socially. Hearing is a social sense which enables crew members to communicate with each other and facilitates good CRM. NIHL can permanently affect people while they are in the aviation industry and have a significant effect upon their lives long after they leave the industry. In many cases it is impractical to eliminate noise from the workplace or to reduce noise to safe levels.

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Some sources of noise hazards for crew include the following: Walking to and from aircraft and through hangers Pre-flight check walk-around Stair access and egress - crew assisting passengers at the bottom of the stairs Propellers noise Engine noise Vibration. Jet engine efflux Noise and interference on HF radio
Effects of Noise on Hearing

The extent of NIHL depends on the intensity of noise, its duration and its frequency (or pitch). The longer a persons ears are exposed to excessive noise, the greater the degree of hearing loss. More time equals more acoustic energy and hence more damage. The damage that results from noise is irreversible, and the treatment is limited. The Act requires employers to identify and control hazards such as noise. NIHL is defined as Serious Harm in Schedule 1 of the Act. The Act establishes a hierarchy of controls for significant hazards and noise is a significant hazard. The Act states that the employer must: Eliminate hazards wherever practicable and control the hazards at source Or isolate hazards if they cannot be eliminated by isolating or insulating the processes that cause excessive noise; or Minimising exposure to those hazards through the use of approved hearing protection. Regulation 11 of the Health and Safety in Employment Regulations 1995 states that hearing protection is only a valid means of control when all practicable steps have been taken to reduce noise to below the stated levels. It is important for employers to note that the aim of the Act and Regulations is to reduce noise exposure to below the hazard criteria stated in regulation 11. The use of hearing protection may be the only means of control that is left for employers. However, hearing protection in the form of earmuffs or plugs is often a misused control option, as its effectiveness in protecting employee hearing depends on: Selecting the correct device Ensuring the device fits properly and is worn correctly The percentage of time the hearing protector is actually worn while an individual is exposed to hazardous noise.

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For these reasons an employer is not meeting their responsibilities under Section 6 of the Act, or Regulation 11 if they provide hearing protection without taking all practicable steps to reduce noise exposure to the level below the hazard criteria. Hearing protection must not be used as a substitute for noise control. The Approved Code of Practice for the Management of Noise in the Workplace goes into significant detail about the requirements for employers in relation to noise hazards and the control steps that are required to be taken. That document explains to employers how they can control noise.
Occupational Deafness

When people suffer from occupational deafness the sounds they hear become distorted, and their ability to hear consonant sounds such as t, k, s, sh, and p is reduced. People also have difficulty distinguishing between some words, and what is being said. Whilst hearing aids can help, they offer very limited benefit for some people with noise induced hearing loss.
Employer Responsibilities

Employers should monitor the risk areas through workplace noise monitoring at no less than five yearly intervals so that objective decisions for the appropriate noise control can be made. Measurement provides a basis for noise control measures to be applied to machinery (aircraft) and equipment and to monitor the effectiveness of controls that have been put in place. Measurements assist to identify hazards and the workers who are exposed to excessive noise levels. Measurements determine whether noise levels exceed an equivalent sound pressure level of 85dB (A) for an eight hour working day, and guide employers as to the appropriate hearing protection that will be required. Employers must monitor the effect of noise on their crew members when they commence employment and thereafter with audiometry at 12 monthly intervals. This must be completed with crew members informed consent to monitor their health in relation to exposure to the hazard) for crew members exposed to noise of 85dB(A) or greater. Employers must clearly identify all noise hazards, inform employees of the hazards, and provide training and information to employees when they commence employment. Then, regularly inform employees about noise hazards involved in their work, including: the effects of excessive noise exposure the control measures implemented within the workplace to control the noise hazard and exposure what the purpose of audiometry is, and what informed consent entails the selection, fit, use, care and maintenance of their hearing protection. All hearing protection provided to crew members should meet the joint Australian/New Zealand Standard for Acoustics Hearing Protectors.

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Employee Responsibilities

Follow the employers instructions regarding noise hazards in the workplace Wear and care for hearing protection such as ear plugs and muffs as trained Report noise hazards Co-operate with the monitoring of workplace hazards and employees health, e.g. noise level monitoring, audiometry. Report work related injuries or ill health, e.g. NIHL.
Recommendations

1. 2. 3. 4.

Refer to CAA Vector article July/August 2008, Hear Today Gone TomorrowHearing Loss: the silent pandemic. Replace earmuff cushions and foam inserts six-monthly and earmuffs annually. Replace reusable earplugs at least three-monthly. Disposable earplugs should be used only once and then discarded. Be aware that hearing loss can come from a variety of sources, including recreational pursuits. Some people are more sensitive to noise than others and can lose their hearing more readily through noise exposure.

Noise Level Figures

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4.4 Stress Workplace stress is described as when someone becomes aware that they are not able to cope with the demands and pressures associated with their work environment and they have a negative response to those demands /pressures. Stress is considered a hazard under the Act. Therefore, it must be managed just like any other hazard. The control methods are to identify the causes of the workplace stressors and then manage these by elimination, isolation or minimisation. This approach means that the impact of the demands and pressure of work, together with the way it is organised, are acknowledged, analysed and managed. This has direct implications for work design, and the length of hours worked; with particular emphasis on the effects of shift work. Stressors are events or circumstances which generally result in pressure on the individual. They can lead to people feeling that they are unable to cope with either the physical or psychological demands of their job. Stress is present in many jobs, and the aviation environment has many potential stressors such as turbulence, in-flight emergencies, noise, disturbed circadian rhythms and irregular night flying quick turn-arounds and preparing the cabin for take-off. They can occur because of the way the work is organised. Stressors may arise from excessive work demands, such as unrealistic deadlines or workloads, or may be disruptions due to weather or mechanical reasons which, apart from being disruptive to the crew members home life, can cause some passengers to become intolerant and difficult to manage. They may also result from personal factors such as health status, injury, relationship problems, or personal ability to cope with situations. Stress on- board an aircraft can increase during periods of turbulence, when passengers are unwell, there is a new crew member, and when working with new equipment and technology. It is important to note that not all stress is work-related. Stress is also associated with life events that are independent of the work environment such as births, deaths, and weddings or financial and other domestic issues. In all situations, individual responses to stress may differ from one person to another. It is crucial that non work related stress is reported as it will increase the likelihood of work related stress manifesting itself. People who are stressed may exhibit some of the following signs and behaviours: Disregard or minimise safety issues and put themselves or others at risk. May have mood changes, seem depressed or experience/exhibit symptoms of anxiety. Develop longterm health problems such as physical or psychiatric disease. Lose confidence, talk about sleeping badly, have slow reactions or behave oddly. Be less able to get along with people that they used to work well with. Become irritable and indecisive, or perform poorly and make more mistakes. Drink more alcohol/coffee/stimulants than usual or use recreational drugs. Complain about their health and, for example get frequent headaches and stomach upsets.
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Employer Responsibilities

Dealing with stress in the workplace is an ongoing task that needs to become part of the organisations work systems. If stress reaches a level that affects the performance of any crew member, then this hazard must be managed so that safety on board the aircraft is not compromised. An employer is required to take all practicable steps for those circumstances they know or ought reasonably to know about. If someone says that they are stressed, or are acting in such a way that most people would agree they were stressed, then employers need to know what is causing the stress symptoms and take appropriate action. Stress can be created either by operational issues, while the aircraft is in motion, or other conditions that arise outside of the flight itself. The following questions can be asked to help assess the presence of workplace stress and to assist with determining controls. Is the work emotionally draining or very unpleasant? Does the work require intense prolonged concentration? Is the work inherently hazardous? Is the workload unrealistic? Is the work too hard for the person? Are there other psychological factors such as conflict or bullying and harassment present in the workplace? Are people separated from their families or friends for long periods of time? Are people forced to both live and work in close confines with people that they may not necessarily get along well with? Is there anything outside of work that is causing stress?
Employee Responsibilities

Learn ways that can help to identify and manage their own stress levels. Be actively involved in identifying areas of work that are stressful and suggesting ways to control them. Recognise and cope with their own stress and perceive and accommodate stress in others, to manage stress to a safe end. Prompt reporting of episodes of stress in themselves and others.
Recommendations

1.

A no blame reporting culture will make employees more willing to provide information. Analysing the information may alert employers and crew members to safety issues and increase stress awareness. Actively involved crew members in identifying areas of work that are stressful and suggesting ways to control them.
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4.5 Fatigue Aviation with its long hours and inherent shiftwork can result in periods of increased fatigue and times when performance will be degraded. Fatigue occurs when there is a mismatch between:
the recovery of the brain and body after that effort the physical and mental effort used during all waking activities

As people become more fatigued they become more forgetful, inattentive, apathetic, and moody. They make poorer decisions, are less communicative, less vigilant, and their responses become slowed and variable.
The Body Clock

Humans are meant to sleep at night and be active during the day. The ability to sleep is related to body temperature, which is at its lowest during the night. As body temperature starts to rise in the morning, the body clock sends out signals to wake up. There are two times of day when the need for sleep is high From about 3:00 am 5:00 am (the highest need) From about 3:00 pm 5:00 pm (siesta time) There are also two times of day when people are most alert Mid-morning to early afternoon Between about 6:00 pm 9:00 pm During these times of high alertness sleep is almost impossible. Jet lag and shiftwork When changing time zones the body will eventually adapt unfortunately, not all of the bodys functions move into the new time zone at the same rate. The new time cues the day/night cycle, meal times, personal activities and the activities of others help move the body clock onto the new time zone. This adjustment is never complete among shift workers. Unfortunately, the imposed sleep/wake cycle is out of step with the time cues in the local environment and any adjustment made while on night shift is quickly reversed during days off. Crew are subject to the problems of both jetlag and shift work.
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Causes of Fatigue

Causes of fatigue fall into two categories, sleep-related and task-related. Sleep-related causes During the day, the longer a person is awake the greater the drive for sleep, and the lesser the drive to remain wake. Eventually the drive for sleep wins, and sleep follows. Going without sleep for long enough will sooner or later end in a period of sleep, irrespective of activity or what the body clock says. There are two distinct types of sleep, non-REM and REM sleep. Both types of sleep are needed in unbroken cycles for a person to be restored and feel well-rested. Humans cycle between periods of non-REM and REM sleep that takes them back into REM sleep about every 90 minutes. Good quality sleep means going through the non-REM/REM cycle with minimum disruption. Illness can often disrupt sleep e.g. coughing, difficulties in breathing, discomfort, pain, etc, at a time when restorative sleep is needed the most. The length of sleep depends on when a person falls asleep. Trying to sleep during the day is difficult because the wake -up signal from the body clock is getting stronger. In addition, noise, heat, and light are greater during the day, so that daytime sleep can be broken and less restorative. The effects of missing a nights sleep have been compared to the impairment associated with alcohol intoxication. Performance continues to worsen the longer a person goes without sleep. Brief episodes of involuntary sleep, called micro sleeps, invade as the drive for sleep builds up. Often these sudden transient bursts of sleep go unnoticed by the sleepy person. With ongoing sleep restriction, feeling sleepy becomes the new norm and with it an increasing lack of insight into personal performance. Task-related causes Difficult and demanding passengers may make a normally easy three-hour flight into a particularly tiring duty period. There is also the fatiguing nature of more mundane or boring activities, those that require long periods of repetitive tasks with little stimulation. Conversely, a high workload, where many activities must be packed into a limited period of time, is also inherently more fatiguing than periods when demands are lower. Environments with low light levels, warm temperatures, high humidity, white noise, and vibration are associated with increased fatigue. There is less stimulation available to help people fight off underlying sleepiness. Making up for lost sleep Sleep is the only antidote for the effects of sleep loss. Fortunately, owed sleep does not need to be made up hour-for-hour. For example, losing a total of 18 hours sleep across a fortnight does not require a 26-hour sleep. Instead, recovery sleep is usually only a bit longer than the baseline sleep requirement and generally occurs over two consecutive nights. It is quality, rather than quantity, that distinguishes recovery sleep. If sleep quality is not optimal e.g. you are suffering from jetlag, or are converting back to night sleep after night shift, then paying back a sleep debt will take longer.
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Signs and Symptoms of Fatigue

The ability to recognise the signs and symptoms of fatigue in both yourself and others is central to the management of fatigue. One way to check on fatigue levels is to answer the following questions: Have I had enough sleep in the last few days? Was it good quality sleep? How long have I been awake? (after 16 hours, fatigue risk will be increasing) Am I coming into a part of the day where sleepiness is high (early morning, or midafternoon)? Each of these factors increases the risk of fatigue being an issue. Skills affected by sleep loss The sort of skills known to be sensitive to sleep loss, and important for many complex tasks undertaken by crew (Harrison and Horne, 2000), include: attending to complex information while filtering out distractions keeping track of an evolving situation and recognising when it is necessary to update a strategy thinking laterally and innovatively assessing risk maintaining interest controlling mood and behaviour monitoring personal performance effective communication Behavioural and personality changes Physical signs of increased fatigue risk yawning heavy eyelids increased blinking eye closing (for very short or very long periods) periods of unresponsiveness slurred or slow speech headaches

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changes in appetite and gastro-intestinal function becoming distracted by minor physical discomforts Someone who is sleepy may forget what they were talking about in the middle of a sentence, or provide an unusually rambling response. While everyone knows that tired people tend to be irritable and cranky, they can also become quieter than normal. Apathy and deliberately ignoring low-effort tasks, (such as normal checks or procedures) because they are too much effort, is also common. Performance Changes Performance changes associated with increasing fatigue. Performance Impairment Attention Indicators Overlooks sequential task element Incorrectly orders sequential task element Preoccupied with single tasks or elements Exhibits lack of awareness of poor performance Reverts to old habits Focuses on a minor problem despite risk of major one Does not appreciate gravity of situation Does not anticipate danger Displays decreased vigilance Does not observe warning signs Forgets a task or elements of a task Forgets the sequence of task or task elements Inaccurately recalls operational events Succumbs to uncontrollable sleep in form of micro sleep, nap, or long sleep episode Displays automatic behaviour Responds slowly to normal, abnormal or emergency stimuli Fails to respond altogether to normal, abnormal or emergency stimuli Displays flawed logic Displays problems with arithmetic, geometric or other cognitive processing tasks Applies inappropriate corrective action Does not accurately interpret a situation Displays poor judgment of distance, speed, or time Exhibits speech effects slurred, rate, content Exhibits reduced manual dexterity key-punch entry errors, switch selection

Memory

Alertness

Reaction time

Problem-solving ability

Physiological effects

Source: Transport Canada

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Personal Strategies for Minimising Fatigue

A variety of strategies are available to help crew manage the effects of fatigue in the workplace and at home. At home Crew must treat sleep as a priority and not an incursion into their time away from work. Meeting sleep requirements before a shift, whether during the night or day, is the best way to minimise the effects of fatigue. Days off are the opportunity to recover from the cumulative effects of restricted sleep across a duty pattern. Paying off a sleep debt requires at least two good nights of recovery sleep in a row. Starting a long-haul trip tired can make jet lag symptoms worse. Arriving sleep-deprived in the new time zone may make it easier to fall asleep on the first night (because sleep drive is so strong), but the second night is likely to be terrible. Long-haul crew seldom have enough time at any destination to adapt to local time. This makes days at home base even more important for recovery between trips. Timing sleep Plan a sleep period to get the maximum benefit. The two times of day when the need for sleep is high, around 35 am and 35 pm, are the best times to be asleep. Siesta time is a good time to top up on sleep requirements, especially before a night shift. There are also two times of day when people are most alert, 1011 am and 69 pm. The maximum drive for waking up occurs in the first period and in effect, means there is a limited biological window for sleep after night shift, making it very important to get to bed as soon as possible. A few hours before the usual sleep time, there is another alert phase (69 pm), this is what makes it almost impossible to fall asleep early before an early start. Get to know your own patterns of sleepiness and use them when you need to sleep and circumstances permit. Nutrition Shift workers are more likely to suffer from digestion problems (from gas to peptic ulcers) and unhealthy eating habits only exacerbate this. If anything, it is even more important to eat a well-balanced diet as a shift worker, as the unpleasant symptoms of gastro-intestinal problems can affect the quality of both sleep and wakefulness. Sleep habits Developing good sleeping habits will help with better quality sleep. Good habits dont go to bed hungry or with an over-full stomach dont drink so much that it increases the need to wake up more often to go to the toilet exercise regularly (not too close to bedtime) can help improve the quality of sleep

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establish a simple pre-sleep routine (having a routine that is transportable can be helpful) make the bedroom conducive to sleep take out the TV, the computer, and the telephone and make the room as dark and as quiet as possible if sleep doesnt come after 30 minutes, get up and do something quiet and relaxing, then go back to bed and try again when sleepy Avoid the following habits: try to go to bed with a zero blood alcohol level by allowing one hour per drink for the processing of alcohol. avoid coffee altogether and nicotine in large amounts before going to bed both are stimulants and will act to fragment sleep heavy exercise before bedtime will make it more difficult to go to sleep At work Napping When extremely tired, some sleep is always better than none. The performance benefits of naps, however, tend to be rather transient; the longer the nap, the stronger the benefits afterwards. In aviation it is imperative a nap is a planned event. Carefully developed guidelines identifying the appropriate times and circumstances related to on-the-job napping must be provided and adhered to. To optimise the benefits of napping, limit naps to either 40 minutes or 2 hours. Adaption to local time On quick turn-arounds on international trips, getting as much sleep as possible, within the limited windows of opportunity, is more important than trying to partially adapt to local time before changing time zones yet again. Sleep debts are accrued when flying across time zones, so maximising the amount of sleep before flying on the next sectors should always be the goal. Times of increased risk Everyone experiences drops in alertness and performance during the night, usually between about 35 am, and again in the afternoon around 35 pm, when the need for sleep is the highest. Be particularly aware of these times when they coincide with other fatigue risks, such as a soporific environment a high and demanding workload a monotonous, unchallenging routine having a sleep debt there being a long time since waking
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very early starts consecutive early starts short layovers large time zone changes the drive to and from work In all of these situations, it is important to be able to recognise the warning signs of increasing fatigue in both yourself and in others. In such high-fatigue conditions, double- and crosschecking may prevent a small slip becoming something much more serious. Short-term alertness maintenance strategies At times there may be no choice but to continue. On these occasions there are strategies that can temporarily improve functioning. Remember these strategies only work for a short period of time and there is no replacement for obtaining sleep. Caffeine The most widely utilised alertness-management strategy is the consumption of caffeine. Points to remember about caffeine: use it strategically dont start taking it when already alert, such as at the beginning of a shift. it takes approximately 1545 minutes to take effect so think about having a drink just before needed the effects of caffeine vary with each person; it can depend on the amount regularly drunk, personal sensitivity, body size and the fullness of the stomach when taken the effects generally wear off in 35 hours, but may take 10 hours caffeine makes it difficult to fall asleep so plan when to stop drinking it caffeine stimulates urine production, so drink other fluids to stay hydrated caffeine in combination with taking a short nap has been shown to be the most effective short term strategy for alertness. Consume the caffeine first then have a short (1530 minute) nap Taking a break Short, regular breaks at work have been shown to be effective in improving physiological signs of alertness in flight crew (7-minute breaks every hour). The breaks included mild physical activity (leaving the flight deck and standing up) and social interaction. However, the beneficial effects only last for 1525 minutes. On the drive home If you feel sleepy while driving, the best thing to do is find a safe place to pull over and take a short (1530 minute) nap. Turning on the cold air, winding down the window, turning on the radio, shifting in your seat are all strategies that do not work.
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Organisational Strategies for Minimising Fatigue

When managing fatigue risk, it is important that consideration is given to the type of activity undertaken and the length of time that performance can be maintained to an acceptable level. Reporting fatigue Everyone has a legal responsibility to report fit for work. For pilots, there are legal requirements in the Civil Aviation Rules. All flight and cabin crew have obligations under the Act. The employer should have policies in place for actions to be taken if crew members feel too fatigued to work. Policies should also guide crew members as to what to do if they feel a duty or roster was excessively fatiguing, they believe fatigue was a factor in an incident, or they think a co-worker is fatigued. It is only through being aware of fatigue-related issues that an employer can take action to correct the situation. Honest reporting is expected in a culture where safety is the primary focus. Fatigue Risk Management Strategy (FRMS) As described earlier, managing fatigue risk is the shared responsibility of not only employers and crew members, but also of the government, regulators, and unions. Traditionally, fatigue has been managed in aviation and other transportation industries through prescriptive limits on maximum hours of work and minimum breaks. This approach recognises the fatiguing nature of increasing hours of work but largely ignores the influence of other factors. It assumes that capping hours of work will result in well-rested individuals who are not vulnerable to fatigue-related errors, however, this is not necessarily so. Many, if not all, operational crew have worked within prescribed flight and duty limitations but have nevertheless been extremely tired, whether because of an inability to obtain adequate sleep, or because the prescribed flight and duty limitations simply did not allow enough time for recovery sleep and the other activities of life. Remember that, while guidelines are in place, the actual hours that crew members can work can differ from what is planned because of factors such as delays, call-backs, altered deadlines or delivery schedules, breakdowns, and shift swapping. Importantly, outer limits for hours of work have generally been set according to industrial agreements, rather than based on scientific evidence or safety considerations. The current state of knowledge supports a more comprehensive approach, one that aims to manage fatigue risks whatever their source, in order to improve safety in the workplace. (FRMS) provide such an alternative. Developing and implementing a FRMS takes time, effort and most of all commitment from the organisation at all levels, including the company and regulatory level and in consultation with crew members. Senior management commitment Senior Management should take part in policy development. Senior management has a responsibility to ensure that regular reporting takes place against the standard operating procedures and, for the evaluation of the FRMS from time to time, to see how it is performing. Counter-fatigue measures should be reviewed against specific standards, and hazard controls should be in place. Management should provide appropriate resources for FRMS and their evaluation.
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Establish line responsibilities A FRMS should be developed that establishes commitment from senior management covers the operational level and describes how the system will work. Standard operating procedures should be in place so crew members are clear as to what they should do if they feel a duty or roster is excessively fatiguing, or they feel generally fatigued to the point it could impact upon their performance and they feel too fatigued to come to work. Incident and accident reporting should be in place for crew members to report if they believe fatigue was a factor in an incident or accident, or if they believe a fellow crew member is fatigued. Education Training and education should be provided on fatigue management for crew members. The training programme needs to be evaluated continually to determine whether: fatigue management strategies are being applied with. there are any gaps in training and opportunities employees are retaining the information. Implementation FRMS should be set within the ambit of a safety management system with multiple strategies against fatigue at various levels. Audit and evaluation FRMS, policies, and procedures should have ongoing evaluation and audit strategies in place. The fatigue training and education programme should be regularly evaluated and updated. In-flight crew rest provisions Long haul aircraft are equipped with onboard crew rest facilities (bunks) to allow crew members an opportunity to sleep. Bunk facilities are a fatigue counter-measure to promote alertness and performance while on the flight deck or in the cabin. Items that should be taken into account when allocating crew rest areas are: ventilation and temperature control crew rests should be ventilated to provide a constant supply of fresh air and should be free of drafts, cold spots and warm temperatures. fire detection aural and visual fire/smoke indication cabin interphone PA lighting emergency lighting should be provided in crew rest facilities.

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attendant call supplemental oxygen and approved oxygen equipment


Employer Responsibilities

Employers have a responsibility to develop safe systems of work and to identify, assess, and control hazards. The coverage of the Act extends to protecting the health and wellbeing of not just employees, but also self-employed people, contractors and their employees, volunteers working in a place of work, and any other person affected by anothers work. Employers need to review the organisations policies and traditional methods of operating alongside the companys legal and operational needs to define who will have responsibility for doing what. They are also required to inform all crew members of any significant hazards in their place of work. This should be provided at induction training, and should include information about fatigue and fatigue reporting systems. As with other hazards in the workplace, fatigue management is a shared responsibility between employers, employees, contractors and principals, and involves factors both inside and outside of work. Employers must provide reasonable opportunity for employees to participate in the ongoing process for the improvement of health and safety. This can include involving crew members in the identification of fatigue hazards and in determining the best controls for those hazards. Crew should also be involved in the ongoing monitoring of those hazards. Employers should foster a no-blame culture when crew report instances of fatigue or fatiguedrelated accidents or incidents. Employers should encourage fatigue reporting, and have fatigue reporting forms that are easy to complete. Fatigue reports should be followed up de -identified and reported on, as any lack of transparency will discourage reporting. Fatigue counter-measure strategies should concentrate on minimising any sleep deficit which accumulates before leaving for a duty, or while on duty. The location of rest facilities or sleeping quarters should be in such a position so that intrusive noise, galley odours, and vibration have a minimal effect upon sleep. When developing rest facilities it is essential to take into account any doors, passenger toilets or public address systems in the immediate area. Stop over accommodation should be carefully researched, sourced, and evaluated to ensure that is not in a particularly noisy or unsafe section of town, and does not require lengthy travel time to reach, as this can use up valuable rest time. Regular feedback should be obtained from crew about the ongoing suitability of their rest and accommodation facilities. Any concerns from crew about their accommodation and rest facilities should be resolved promptly.
Employee Responsibilities

Crew members have a responsibility to arrive fit to work including attending training, and to behave safely in the workplace. This includes arriving at work as well rested as possible by using recovery and rest periods appropriately, and understanding and managing fatiguerelated risks in the workplace.

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Crew members should work with their family and friends to factor adequate sleep into their lifestyle. Effort should be made to set aside extra time for sleep for two to three nights before an international flight to avoid starting off with a sleep overdraft. Crew rest areas should be checked before flight by the ISCs (or their delegates), and checked again immediately after they have been used. Equipment in crew rests must not be tampered with, especially lights and lighting controls, and any equipment malfunctions should be reported immediately.
Recommendations

1.

A no blame reporting culture will make employees more willing to provide information. Analysing the information may alert employers and crew members to safety issues and increase fatigue awareness. Supervisors should be alert for signs of fatigue. A questionnaire to monitor the individual effects of shift work can be circulated to all crew members at regular intervals, or be available for individuals to complete at any time. At agreed intervals the employer needs to carry out an evaluation of the fatigue management system, and should involve crew representatives during the evaluation process. Managers should be aware of the warning signs that an individual is not coping or is fatigued. This is significant, as some people do not cope well with shift work, especially when concerns outside the workplace are more worrying than usual e.g. when they have a sick relative, relationship problems, or bereavement. Meals should be taken in the crew rest areas to avoid interruptions and to aid digestion. Duvets/blankets should be available for crew to use in crew rests, to assist with maintaining a warm body temperature.

2.

3.

4.

5. 6.

Further information from overseas experience on FRMS can be found in the Flight Safety Digest (AugustSeptember 2005) and on the Transport Canada website (www.tc.gc.ca). 4.6 Drugs and Alcohol Based on the use of alcohol and other drugs in the general population, it is reasonable to assume that people in particular industry sectors may also be users of alcohol and other drugs. Therefore, there is the potential for cabin crew and flight crew to be on duty when affected by alcohol and other drugs if they are not used in a responsible manner. The effects of alcohol and other drug use in the context of their impact on the working environment are often referred to as substance impairment. The following information sets out some recommendations as to how drugs and alcohol use (or misuse) could be managed in the cabin and flight crew environment. Civil Aviation Rule 19.7 states: Intoxicating liquor and drugs No crew member while acting in his or her official capacity shall be in a state of intoxication or in a state of health in which his or her capacity so to act would be
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impaired by reason of his or her having consumed or used any intoxicant, sedative, narcotic, or stimulant drug or preparation. While substance impairment is not clearly identified as an issue in cabin crew and flight crew accident and incident data, this guideline represents an opportunity to proactively manage this and prevent it becoming an issue. The CAA Communications & Safety Education Unit produces education material such as posters on this subject, encouraging industry participants to be aware of the unnecessary risks involved with flying and substance impairment and, to act appropriately. Educational material is available on the CAA website www.caa.govt.nz.
Employer Responsibilities

Employers should have processes in place to manage reports of substance impairment of crew. Employers in conjunction with employees or their representatives should develop a substance impairment testing policy and processes to address their responsibilities under the HSE Act, or more generally as part of any employment agreement.
Employee Responsibilities

There are a number of actions crew can take to ensure safety with respect to the influence of alcohol and other drugs as follows: do not use alcohol or other drugs in the period of time preceding duty. do not go on duty if you are in any way impaired due to alcohol and or drugs. do not use alcohol or other drugs during the duty period. identify behaviours associated with substance impairment - look out for it amongst your fellow crew members. advise the FSM (or PIC) if you suspect a fellow crew member is impaired by any substance including when you arrive at work, not just onboard the aircraft. do not condone inappropriate alcohol or drug use in the work environment e.g. during layovers. if a crew member believes they have a substance impairment problem they should speak to their employer and/or your doctor and ask them for help. be aware that alcohol or drug use associated with other risk factors such as fatigue or dehydration, can also significantly affect crew members performance on the job and ultimately affect safety. passengers have a high level of interaction with cabin crew - you are the face of the airline. Crew members must be capable (and be seen to be capable) of being trusted and responsible in their role, particularly in emergency situations. if crew members are taking any prescription medication that may impair/affect their operational performance, they must advise their employer. Their employer may assign such crew members to other less safety sensitive duties in the interim.

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Recommendations

1. 2. 3.

When a doctor prescribes medication for crew members he or she should be advised of the safety sensitive nature of the crew members work. They should be asked if it is possible to prescribe medication that does not impair the performance of work duties. The employee should advise the employer if they are taking medication.

4.7 Bullying and Harassment Harassment occurs when an employee is subject to continuous, repeated or prolonged verbal, written, email or physical behaviour which is unwelcome, personally offensive and fails to respect the rights of others. Workplace harassment which includes bullying can be harmful to the person being harassed; they can feel isolated, lose confidence, have feelings of not being able to cope and may worry about being able to cope in the future. It can impact upon home life and affect an organisation with increased staff turnover and costs, lower productivity, absenteeism, low morale and unsafe work practices. It is important to note that occasional differences of opinion, conflicts or problems in working relationships are part of working life and do not necessarily constitute harassment. The following are some examples of behaviour that are not considered harassment: Issuing reasonable instructions and expecting them to be carried out. Insisting on high standards of performance in terms of quality, safety, and team co operation. Giving negative feedback, including in a performance appraisal, and requiring justified improvement.
Employer Responsibilities

The prevention of harassment can be helped by employers establishing clear policies and procedures and providing training in relation to those procedures. Employers should appoint a contact person, encourage incident reporting, and investigate all complaints and respond promptly to complaints. There needs to be more than one contact person available, to allow for situations where there is harassment by someone in a managerial role. With extreme cases of harassment, particularly where it involves people in positions of power or authority or people skilled in exploiting situations to the disadvantage of others, senior managers need to take the lead to investigate complaints of workplace harassment , assess the degree of risk posed to others, and devise appropriate strategies to minimise this risk.
Employee Responsibilities

Employees have a duty to look after their own safety and health at work and ensure that they do not harm others; this is also a general duty under the employment relationship. If an employee believes they are being harassed, they should document all incidents and report the problem to their manager.
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Recommendations

1. 2. 3.

4.

Senior management should monitor staff turnover, as a number of resignations is often reported as a sign of a workplace bully. Confronting bullying and harassment is the responsibility of everyone in an organisation, there should be zero tolerance to this. Mediation, while voluntary, is a mechanism that can be used to resolve employment relationship problems and may be useful in determining whether the issue is bullying or harassment or another underlying problem. All people involved in a complaint should be offered a support person of their choice when attending meetings. All crew members should undertake CRM training each year, to help with the lines of communication and to better understand other work colleagues.

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Section Five Training and Emergency Response


5.1 Training Training provides for interaction between aircraft manufacturers, employers, cabin crew, flight crew and the aviation regulatory environment in which the aircraft is be operated. Airline pilot training has undergone significant changes in the last two decades. Airline pilot training was previously concerned with developing and maintaining technical skills. Today, behavioural skills are considered essential, as operating an air transport aircraft in todays environment is a team task. Cabin crew members are primarily to ensure passenger safety but also to provide a service. Cabin crew members are unique among airline personnel because they have these two distinct responsibilities, with the most important but the least visible being the safety of aircraft passengers and the aircraft cabin.
Cabin Crew Members

As cabin crew duties and responsibilities in air transport operations are safety related, their training should reflect this fact. Crew members must be given enough information and practice with equipment and situations to master and be able to demonstrate skills they would need in an emergency situation. Cabin crew members must undergo specialised and thorough training, not only to gain a sound knowledge of their safety related responsibilities, but also to instil confidence and to provide them with the authority needed to perform their duties. Crew members should be able to demonstrate proficiency and knowledge in exit operations, evacuation slide or life slide/raft inflation and disconnection, locations of equipment, knowledge of chemically generated oxygen systems, use of checklists during an emergency, crew communication and an ability to follow established or standard operating procedures. One of the biggest challenges in training is the transfer of the skills and information learned in the training to the workplace, (the theory practice gap). This highlights the importance of simulation and mock-up fidelity. Training cannot duplicate every situation cabin crew come across in the performance of their duties but through training, basic knowledge, skills, attitudes, and confidence can be instilled to enable crew to manage emergency situations. Information and training should also be given on how to deal with fires involving portable electronic devices. This will be covered in the (ICAO) Emergency Response Guidance for Aircraft Incidents Involving Dangerous Goods which will become effective from 1 January 2009, and will provide a suggested checklist for operators to use. As the structural strength of transport aircraft improves and accidents become more survivable, crew members play a more critical role in ensuring passenger safety. Cabin crew members play a key role in accident prevention and in the assistance they give to passengers after an accident. Therefore, it is imperative that employers implement training programmes for cabin crew which consistently result in no less than a minimum level of proficiency that enables cabin crew to undertake their duties and responsibilities effectively and efficiently.

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Types of Training

Regulatory provisions require that cabin crew members complete the operators training programme annually. Cabin crew members are also required to be knowledgeable about the location and operation of safety and emergency equipment for each type of aircraft they operate, and trained to deal with both normal and emergency safety situations, relevant communication, and crew coordination. Initial training is required for persons who have not previously been employed by the airline as cabin crew members. For initial training to be effective, it should be rapidly followed by line indoctrination. Line indoctrination should be accomplished with an acceptable student to instructor ratio. Where there is more than one student to instructor, safeguards must be in place to ensure proper training, supervision, and evaluation by the instructor. Cabin crew must complete a recurrent training programme during each twelve month period following initial or previous recurrent training. Recurrent training is mainly provided to ensure the maintenance of knowledge and skills thorough a series of drills, exercises, and quizzes to familiarise crew members with new procedures and/or equipment introduced since their last training.
Employer Responsibilities

Section 11 of the Act, Training and Supervision, requires employers to take all practicable steps to ensure that employees either have or are supervised by a person, who has experience in working on board an aircraft in operation. This requirement is to ensure the crew member does not harm themselves or other people, and that crew members are adequately trained in the safe use of all plant, objects, substances, and protective clothing and equipment the crew member is or may be required to use or handle on board aircraft. In addition to Act requirements, ICAO Annex 6 Part 1, require the following. Flight crew training programme Operators are required to establish and maintain an approved ground and flight training programme which ensures that all flight crew members are adequately trained to perform their assigned duties. The training programme must include the following: ground and flight training facilities and properly qualified instructors ground and flight training in the type(s) of aeroplane on which the flight crew member serves proper flight crew coordination and training in all types of emergencies and abnormal situations or procedures that are caused by power plant, airframe, or systems malfunctions, fire or other abnormalities training in the knowledge and skills related to visual and instrument flight procedures for the intended area of operation, human performance including threat and error management, and in the transport of dangerous goods ensure all flight crew members know the functions they are responsible for and the relation of these functions to the functions of other crew members, particularly in regards to abnormal or emergency procedures, and recurrent training including an assessment of competence
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Employee Responsibilities

Pilots need to have knowledge of airport signage and markings and the local procedures pertaining to each airport. Cabin crew are also required to be knowledgeable about the location and operation of safety and emergency equipment for each type of aircraft they operate, and must be trained to deal with both normal and emergency safety situations, relevant communication, and crew coordination.
Recommendations

1. 2. 3. 4.

The principle purpose of cabin mock-ups, doors and other training devices should be to provide realism during training for emergency situations. Cabin door simulators should accurately demonstrate the characteristics of cabin doors Training devices should be reviewed annually. Evacuation trials conducted with non-toxic smoke will more realistically demonstrate the difficulty of evacuating a smoke filled aircraft.

5.2 Crew Resource Management (CRM) and Team Performance CRM is a concept to utilise and improve the resource management skills of flight crew, cabin crew and others in the aviation sector. It is a management system that effectively uses all available resources such as equipment, procedures, and people to promote safety and enhance the efficiency of flight operations. CRM is just one of the practical applications of Human Factors; it can be approached in many different ways, but there are some essential features. There should be a focus on the training of crew members as a team, not just as a group of technically competent individuals. The outcome is for crew members to work together, and oopportunities should be provided for crew members to practice their skills together in the roles they would normally perform in flight. The programme should teach crew members how to use their interpersonal and leadership styles in ways that foster crew effectiveness. It should also teach crew members that their behaviour during normal routine circumstances can have a powerful impact upon how well the whole crew functions during high workload and stressful situations. Similar situations experienced in training increase the probability that a crew will handle real stressful situations more competently. To improve aviation safety and security on board aircraft, flight crew and cabin crew need to communicate, cooperate, and work as a team. This is the role of CRM. ICAO has defined CRM as the effective utilization of all available resources to achieve safety and efficiency. Furthermore, ICAO has adopted the concept of CRM as an error management tool.

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CRM training should include at least three distinct parts: 1. 2. 3. Building an awareness, where CRM issues are defined and discussed, as the concept must be understood Practice and feedback, where trainees gain experience with CRM techniques. Certain skills must be taught and interactive group exercises must be accomplished. Continual reinforcement, where CRM principles are addressed on a long-term basis. To be effective, CRM training must be accomplished in several parts and over several years.

Skills that need to be developed include: Communication/interpersonal skills. Effective communication forms the basis for successful teamwork. Rank, age, crew positions, attitudes and cultural differences can all affect communication. Situational awareness. Described as a total awareness of the surrounding environment, so the crew member can differentiate between reality and the perception of reality. The differentiation enables crew to control distraction, enhance monitoring and cross checking, and to recognise and deal with themselves and other crew members who are incapacitated. Problem solving and decision making. Aimed at developing conflict management within a time constraint. Conflict can be immediate or ongoing and can require direct responses or tact to cope with it. The aim is to develop aircrew judgement within a certain timeframe; skills will be developed that are required to bring conflict to a safe end. Leadership. Teams need a leader to function effectively. The success of leadership skills depends on the understanding of components such as managerial and advisory skills that can be taught and practised. Improving leadership skills allows the team to function more efficiently. Stress Management. Factors that contribute to stress include mental and physical fitness, fatigue, social constraints, and environmental constraints. Stress management is about recognising those factors, dealing with stress on an individual basis and helping others to manage their own stress. Critique. Undertaken to improve knowledge, skills and understanding. Critique includes the review of actual airlines accidents and incidents to create problem solving dilemmas that aircrew should act out. Critique, through the use of feedback, enhances crew members awareness of their surrounding environment, assists them to recognise and deal with similar problems, and helps them to resolve situations that may occur. For a CRM program to be successful, it must be embedded into the full training programme, be continuously reinforced and become an inseparable part of an organisations culture. CRM requires the support of senior management. CRM should be a regular part of the recurrent training requirement and should include refresher information, and practical and feedback exercises. It is of particular importance that some recurrent CRM exercises take place as a full crew; this enables crew members to operate

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in their usual positions. For example, recurrent training emergency evacuation exercises designed for CRM should only be conducted with complete crews. Joint training of cabin and flight crew members enables emergency exercises to be conducted in a more realistic environment and permits flight crew to interact directly with cabin crew. This encourages all crew to actively consider and recognise each others needs and directly demonstrates and emphasises the inter-relationship between actions in the aircraft cabin and flight deck. LOFT is an integral part of CRM training where, the philosophy of CRM skills is reinforced. LOFT refers to aircrew training which involves a full mission simulation of situations which involve communication, management, and leadership. It is considered a practical application of CRM training, and should enhance the principles developed and allow a measurement of their effectiveness. Team performances are becoming increasingly relevant in many operational settings. CRM is a standard method used in civil aviation to support team performance; it establishes a team approach to solving problems that can arise within the aircrafts work environment. It is also recommended that CRM be integrated into simulator, line checks and first aid training. Two issues that may impact team performance are cultural diversity and aircraft type. Raised awareness about cultural diversity among cabin crew members can enable and support strong team performance. With respect to differences in aircraft type, it may be necessary to determine the impact of working on diverse aircraft on cabin crew and flight crew team performance levels. On 8 May 2008, New Zealand introduced an English language proficiency test for all new pilots licenses issued in New Zealand. Team performance in different aircraft types The outcome of some cabin crew working on numerous aircraft types means they are required to hold large amounts of information and procedures. A common factor that has emerged from incident investigations, independent of the carrier aircrafts State of registry and culture of the crew, is that multi-type crew who work on different aircraft can be a source of confusion in emergency situations. This confusion can result in a lack of crew coordination between cabin and flight crew in an emergency, especially with crew that have not participated in joint crew emergency procedures training. (ICAO Human Factors Digest NO 15 2003).
Employer Responsibilities

CRM should be a regular part of the recurrent training requirement and should include refresher information, and practical and feedback exercises. There should also be a focus on the training of crew members as a team. Procedures should be in place to ensure that crew briefings are performed prior to every flight; these briefings should be concise yet comprehensive. With respect to multi-type crew working on different aircraft type, employers should have procedures in place to minimise the risk of these crew being a source of confusion in emergency situations.

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Employee Responsibilities

To improve aviation safety and security on board aircraft, flight crew and cabin crew need to communicate, cooperate and work as a team. Crew members should use effective communication, as this is important for crew briefings and procedures to optimize co-ordination. Raised awareness among crew about cultural diversity can enable and support strong team performance.
Recommendations

1.

2. 3.

Joint training of flight crew and cabin crew is preferred as it allows for emergency exercises to be conducted in a more realistic environment and permits flight crew to interact directly with cabin crew, thus resolving communication and coordination issues. It has the added advantage of ensuring that cabin crew and flight crew are exposed to each others professional culture. Joint training could be arranged as a rostered duty where crew can go through scenarios, this may need to be a night shift to use aircraft parked at the gate. At pre flight briefings, a scenario could be given, and each cabin crew member should be able to say how they would respond to that situation (for what position they are working in that day). The scenario will highlight if any cabin crew are not clear, this is particularly relevant to multi-type crew members who work on different aircraft.

5.3 Emergency and Safety Procedures, Cabin Crew Briefings and Passenger Briefings
Emergency Situations

Emergencies that occur during take-off or landing tend to be unexpected and leave only a minimum of time to react. In order to recognise an abnormal situation, crew need to be aware of what is normal and what is abnormal; especially, in the take-off and landing phases. Crew may also need to determine the necessity to prepare passengers for a possible impact situation. The sorts of clues that may alert cabin crew of an impending emergency are: sparks, fire, or smoke unusual noises impact forces abnormal aircraft attitude The sequence of actions to be taken, and the associated commands and announcements to be made by crew for planned and unplanned emergency situations, should be provided in planned and unplanned emergency checklists. Cabin crew must be prepared to evacuate the aircraft if an emergency situation develops and an evacuation is required.

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Safety manual Emergency Procedures Format

The following are suggestions: Checklists tabbed red to indicate importance and placed into the inflight safety handbook. Pages made of cardboard with a colour coding that corresponds with the type of emergency for example: Water blue Land tan

These pages should be visible for reading at night. Ditching cards should be laminated for use in the water. It is preferable for all information to be included in one foldout page for easy reference. This information should be placed in an easily accessible and secure location. The PIC will advise the FSM of an emergency situation as soon as possible. The FSM will then obtain the necessary information to prepare the cabin crew and the cabin.
Cabin crew Briefings

Cabin crew briefings must be conducted for, but not limited to, pre-flight and first departure of the day. Cabin crew briefings should be conducted following changes of aircraft type or crew, and where there has been a layover of more than two hours. All crew members in charge should emphasise the different operating procedures specific to each aircraft type during the preflight safety briefings.
Employer Responsibilities

Air operators should have clear policies about the following. Exit seat assignments by check-in agents. Ground crew should be aware of what aircraft type is operating the flight as emergency rows may change. What to do if a crew member believes that a passenger in an exit seat might impede an evacuation. The provision of passenger information sheets for emergency exit seats, and the need to follow up with passengers to ensure they understand the safety information provided. The need for advance briefings of cabin crew and passengers about aircraft configuration, specific restrictions, facilities and the seating of passengers who have special seating requirements. For each aeroplane type, assign to all flight crew members the functions to be performed in an emergency or in a situation requiring emergency evacuation. Include annual training to accomplish these functions in the operators training programme. Training must include instruction in the use of all emergency and life-saving equipment that is required to be carried and drills in the emergency evacuation of the aeroplane. To ensure compliance with Civil Aviation Rule Part 91.115, ensure the minimum number of cabin crew required for each aeroplane type is assigned. This is based on the seating capacity or the number of passengers carried, to effect a safe and expeditious evacuation of the aeroplane, and the functions to be performed in an emergency or a situation requiring
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emergency evacuation. The air operator must assign these functions for each type of aeroplane type. Establish and maintain an approved training programme, to be completed by all persons before they are assigned as a cabin crew member. Cabin crew members must complete a recurrent training programme annually to ensure that each person is competent to execute safety duties and functions which the cabin crew member is assigned to perform in the event of an emergency or in a situation requiring emergency evacuation.
Employee Responsibilities

Cabin crew should re-locate elderly or disabled passengers and children from exit row seats. Passengers who need an extension belt and passengers who have infants should not occupy these seats. This is particularly important with passenger self check-in. Cabin crew must ensure that, by means of a passenger pre-flight briefing, passengers are made familiar with the location and use of: Seat belts Emergency exits Life jackets Oxygen dispensing equipment Other emergency equipment provided
Recommendations

1. 2.

Emergency procedure instructors should visit newly delivered aircraft to highlight, during training, any addition or changes to the location of safety equipment. Cabin crew should work with passengers to ensure they are paying attention to the safety information being given prior to take-off and landing, and that they are not preventing other passengers from hearing the safety information. Differences in each aircraft type should be emphasised periodically in cabin crew circulars. The number of aircraft types cabin crew may operate should be restricted to not more than three.

3. 4.

5.4 Aviation Medicine First Aid Training and Equipment In addition to their safety related duties on board aircraft, cabin crew members may be required to administer first aid to passengers and to assist with various in-flight medical emergencies. With the increase in travel and the age of travellers, more passengers are likely to develop illness in flight. Crew members may be required to assist passengers who become ill during flight and to administer appropriate treatment within the parameters of the training they have been given. Accordingly cabin crew must be appropriately trained in first aid administration, and life support procedures, and in the use of all emergency equipment carried. Cabin crew first aid training must include basic care principles, anatomy and physiology, and an overview of the human body looking at organs and systems. The symptoms of typical
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illnesses most likely to occur during flight, including procedures for their temporary treatment, must also be described. In addition to theoretical explanations, cabin crew must receive practical training in cardiopulmonary resuscitation (CPR) life-saving holds such as the Heimlich manoeuvre, and correct positioning of the body, for example, positioning of an unconscious passenger into the recovery position. Civil Aviation Rules require first aid kits to be carried on aircraft used for air transport operations, and on any aircraft with 10 or more passenger seats. Regulation 4 of the Health and Safety in Employment Regulations 1995 requires employers to take all practicable steps to ensure facilities, including first aid facilities, are provided at every place of work under the control of that employer. Every aircraft that cabin and flight crew members are employed to fly in is deemed to be a place of work, so air operators are required to ensure that aircraft first aid kits are fitted and properly maintained. Certain work environments have greater risks of injury and illness, due to the nature of the work being performed and the length of travel away from medical facilities. This is an important criteria for deciding first aid requirements, as different first aid facilities may be required for different activities
Employer Responsibilities

To reduce the likelihood of contracting transmissible diseases from passengers when providing care, crew members should be trained in the appropriate protection against airborne, fluid-borne, food-borne and insect-transmitted diseases. A post-exposure action plan should be in place for crew members who believe they have been contaminated by a biological hazard. The plan should incorporate: immediate reporting of the incident to their ISC a needle stick procedure immediate post-flight access to medical care follow up care This topic is covered more fully in an earlier section of the guideline under biological hazards to crew health. Cabin crew must be trained to readily recognise when a first aid emergency exists and be able to provide basic care until medical help arrives. Practising first aid techniques during training increases crew members confidence and helps to lessen anxiety. Training should also take into consideration the lack of space on board aircraft, associated manual handling issues, how to use the variety of equipment on board aircraft including standard aircraft first aid kits, physicians kits and defibrillators where available. A quick reference manual for first aid treatment of commonly occurring medical conditions should also be available on board each aircraft for cabin crew to use. Operators must establish approved health and safety policies and procedures for handling a severe case of illness on board an aircraft and for the use of medical kits. A list of contents for

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the medical kit must be readily available, but in a safe place, for review without the kit being opened. First aid facilities and trained first aiders should be available on board aircraft whenever work is in progress. A first aid box or cabinet should be located close to washing facilities (including hot and cold water, soap and towels) and should be stocked with first aid equipment and materials appropriate for the work being undertaken and the number of crew members on board. When determining the number of qualified first aid personnel needed in a workplace, employers/operators should complete a risk assessment process which will include: the number of crew members at work the needs and number of passengers the degree of risk the route to be travelled First aid kit inspections should be undertaken and should confirm that first aid kit locations and labelling are in accordance with Civil Aviation Rule 91.523 Emergency equipment. Air operators must review their first aid needs on a regular basis, and particularly after any operating changes, when the crew members have reported that the kit has been used, when an item in the kit has reached its expiry date, or new equipment or procedures are introduced, to ensure that the provision for first aid remains appropriate.
Employee Responsibilities

All aircrew should adhere to the blood-borne pathogens standard which presumes that all human blood and body fluids are potentially a risk. All crew members must practice precautions to prevent direct contact with blood or body fluids (as in CPR), and other medical duties. After treating passengers or crew members, all items should be disposed of into appropriate containers for e.g. sharps containers and biohazard waste bags.
Recommendations

1.

Employers should decide on the contents of the first aid kits by taking into account the operating environment, routes to be flown, the type of operation, the number of passengers carried and the types of accidents and injuries that can occur on board. As CRM establishes a team approach to solving problems that can arise within the aircrafts work environment, it is also recommended that CRM be integrated into first aid training, so that cabin crew and flight crew can work with each other if necessary, in assisting unwell passengers and or crew with first aid and medical requirements.

2.

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