Helicopter maintenance error analysis: Beyond the third order of the HFACS-ME
Helicopter maintenance error analysis: Beyond the third order of the HFACS-ME
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DOI：
10.1016/j.ergon.2010.04.005
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发表时间：
2010-11-01
影响因子：
3.1
通讯作者：
Braithwaite, G. R.
中科院分区：
文献类型：
--
作者：
Rashid, H. S. J.;Place, C. S.;Braithwaite, G. R.
本文通过对58起直升机维修安全事件的统计分析，研究了直升机事故和事件的生存性及其严重程度分布。还进行了分析，以确定直升机的主要和子系统最容易受到维护错误，并确定各种类型的这种错误。研究了受影响的旋翼机部件与相关维修错误类型之间的预期固有关系。这些事故和严重事件的人为因素为基础的触发器进行了探讨。具体故障（SFs）的概念，紧接在每一个这样的事件被引入更详细的表示最后违反个人和组织的安全屏障。然后，利用人为因素分析和分类系统-维护扩展（HFACS-ME）分类法（重点关注其三级类别列表）寻找这些安全事件的根本原因。根据根本原因调查结果，讨论了影响维护、修理和大修组织（MRO）内个人和组织行为的旋翼机特性。与行业的相关性：直升机维修业中人的可靠性研究强调对维修人员错误的原因和传播机制及其对整个航空安全的后果的理解。以前的作品经常调查维修错误及其在促进固定翼飞机的航空事故中的作用;本研究正在调查旋翼机的情况。(C)2010 Elsevier B. V.保留所有权利。
In this paper a statistical analysis of a sample of 58 helicopter maintenance-induced safety occurrences is conducted to study helicopter accidents and incidents' survivability and the severity distribution of such occurrences. Analysis is also carried out to identify helicopter main and sub-systems mostly exposed to maintenance errors and to determine various types of such errors. Expected inherent relations between rotorcraft components affected and types of associated maintenance errors are investigated. Human factors-based triggers of these accidents and severe incidents are explored. The concept of Specific Failures (SFs) that immediately precede each of such occurrences is introduced for more detailed representation of the last breached individual and organizational safety barriers. Root causes of these safety occurrences were then sought utilizing the Human Factors Analysis and Classification System-Maintenance Extension (HFACS-ME) taxonomy with a refined focus on its third order categories' list. The rotorcraft characteristics influencing individuals and organizational behaviours within Maintenance, Repair and Overhaul organizations (MROs) are discussed in the light of the root cause investigation results. Relevance to industry: The study of human reliability within helicopter maintenance industry is waited to emphasise the understanding of causes and propagation mechanisms of maintainers' errors and their consequences on the overall aviation safety. Previous works often investigated maintenance errors and their roles in promoting aviation accidents of fixed-wing aircraft; this research is investigating the case of rotorcraft. (C) 2010 Elsevier B.V. All rights reserved.