Slide no 3: from this video we can see that even after watching a defected electric wire the

mother did not take any action. For which it led to an accident. Where as only reporting to
responsible authority could save the teenager from accident. Just like this incident in aviation
also only reporting to responsible authority can mitigate a probable hazard and ensure
maximum flight safety.
Air officer commanding baf bashar, air officers, oc wgs, officers and gentlemen present
assalamualaikum and good morning. I welcome you all in command safety week opening
ceremony.
Slide no 10: Today the topic of my presentation is
Slide no 11: The aim of my presentation is
Slide no 12: For that I will discuss about
Hazardous factor
Identification of hazards
Reporting and safety cultures
Recommendation
At last if Q & A if you have any query

Slide no 13: to identify hazard we should know about the factors which may lead to a hazard in
aviation. all probable hazards in aviation may be created by four factors.
They are human, aircraft, environment and external pressure.
Slide no 14: let’s go through a case study to witness how these factors lead to a flying hazard.
Slide no 15,16: on 24 aug 01 at 0052 UTC an airbus a330 of air transat airlines took off from
Toronto intl airport with 306 lives and 46.9 tons of fuel, 60 nm south for traffic adjustment, after
five hours low oil temp, high oil press, no action on check list, later get fule imbalance, caution
no crossfeed if fuel leak, calculate fuel and assume fuel leak, more than 300nm to lisbon, decide
to divert to lazes, at night no visible fuel leak, declare fuel emergency 05;45,0613 eng rt fail,
decide to descend from 39000 to 33000ft, 135 nm from lazes, 0626 lt eng fail, glide almost
75nm and force land, 8tyrs burst and all saved with minor injuries.
Slide no 17: after the incident immediately an investigation team was formed. The first finding by
the investigation team was there was a fuel leak in rt wing tank. While investigating further to
find out the reason of the leak the investigators were shocked. They found out that th rt eng was
overhauled 2 months before the incident. After receiving the eng the maintenance crew found
out one hydraulic pump and pipe is missing. At this time the chief maintenance crew instructed
them not to wait for the pump and fix it by taking pump and pipe from an old engine. This old
pipe was only milimeter bigger than standard pipe. That’s why there was no gap between fuel
pipe and hydraulic pipe. And for the last 2 month due to friction this fuel line got leaked.
Only reporting to responsible higher authority could stop the incident to ever happen.
Slide no 18: as we know how these factors lead to a hazard. Lets learn how to identify these
factors so that we can report about probable hazard
HUMAN: To identify probable hazard due to human we can look for some key elements.it can
be self-evaluation or you can check others on these aspects.
Knowledge: Is there any lack of knowledge which may lead to a hazard
Experience: does the operator have adequate experience for the task
Training: we already saw how wrong training can cause loss of lives
Proficiency: Am I proficient enough for the task or action?
Recency: How much current is the person detailed for the job? Does it compromise flight
safety?
All together a simple acronym: NXTPR

Also, every human specially pilot must be concerned about his health. Otherwise, it may lead to
probable hazard
It can be done by:
Illness: am I sick?
Medication: Am I taking any medications that might affect my judgement?
Stress: Am I under in any stress due to job, money or family problems?
Now here Stress is not always negative. The only people who feel no stress are dead people.
Different people have different degrees of resistance to stress. The amount of stress associated
with optimal performance varies from person to person. The important thing is to identify the
limiting amount of stress for YOUR ideal performance and stay within that limit.
When you are under low stress, you get bored and fall asleep. Performance is low. When stress
exceeds your acceptable amount, you panic and performance declines.
Alcohol: have I been drinking within 8 hours? This is less important considering our culture and
religion.
Fatigue: am I tired and not adequately rested?
Emotion: am I emotionally upset? The US Bangla aircraft crash is an example for that.
AIRCRAFT: to identify the risk regarding the aircraft you have to evaluate the serviceability.
With an easy acronym FEWMAP that follows,
Fuel: what’s the aircrafts fuel consumption? Does it have enough fuel for the mission? Do not
rely on a forecasted tailwind; anticipate headwinds. Be meticulous about FHARTI checks on
waypoints.
Equipment: Is the aircraft adequately equipped?
Communication/Navigation
Clothing and survival equipment

Weight and Balance: Make sure weight and balance is within the limits.

MAINTENACE: Does the aircraft have any maintenance problems? Was there any rectification
or troubleshooting by the engineer or grd crew? Are all the parts approved and updated for
aviation?

Airworthiness: Check all aircraft documents. Do a complete walk-around.

Example: during a pre-flight, a pilot noticed a small amount of oil dripping from the bottom of
cowling. Though the quantity of oil seemed insignificant at the time, pilot decided to delay the
takeoff and asked a grd crew to check the source of oil. The pilot’s good judgement was
confirmed when the grd crew found that one of the oil cooler hose fittings was loose.

Performance: What are the aircraft performances?

take-off distance;
obstacle clearance and climb;
landing distance.

ENVIRONMENT: the pilot should evaluate the SURROUNDINGS of the flight.

Weather: For Weather cater METAR, TAF, wake turbulence all in your account to mitigate risk.
Airspace: this includes destination airport, alternate airfield and enroute. Know about the
NOTAM, comm/nav facility IFR/VFR facility of the destination and enroute.
Nighttime: this requires special consideration. So be cautious about IFR and surroundings of the
landing airfield and its lighting facility.
Terrain: At last, for Terrain a pilot should know the MEA, obstacles around an airfield for safe
operation.
EXTERNAL PRESSURE: External pressures are certain situational influences to the flight that
create a sense of pressure to complete a flight.
PILOT must ask himself what are the reasons to maintain the schedule. What are the risks
behind this is it worth to maintain the schedule?
Is there any passenger pressure?
Is he going for the mission just to show his pride? To demonstrate his qualification? To impress
someone? At the expense of SAFETY?
Lastly, get there itis: to mitigate this risk he must ask himself is he thinking that he has to get
there by anyhow? An example of it can be given as you landed on chattogram due weather and
started panicking that you have to go back to your home Bangabandhu because you have a
dinner party to attend!!

Till now we learnt about probable hazards, their identification. Also, already we can understand
that only reporting can solve many probable hazards. But how to report?
As per AFO there are procedures & forms to raise a report after an incident. But there is no
official format to report a probable hazard. So, for now the best way is to report the situation to
your superior verbally and also make a soft copy of it for digital date confirmation. So that even
after reporting due to the carelessness of the superior any incident occurs you can show that
copy to investigating authority.
Another bigger issue regarding reporting is even after identifying probable hazard there will be
someone who won’t report due to some reason, who will just watch and avoid. In aviation we
don’t want that. It’s a risky business. even a minor ignorance can be fatal. We can’t compromise
flight safety for those kinds of people. That’s why it’s not about learning and reporting only. It’s
about a culture of reporting. For example, as a Bengali culture all celebrates pahela baishakh
regardless of your beliefs. Everyone endeavors to have a bite of hilsha on that day.
We want that kind of cognitive implantation in every airmens brain. So that regardless of your
duty and appointment you look for and report a probable hazard to responsible authority
whenever you see it.
Who wants to be the part of that culture? No one? The voice is very low.
That’s good. In relation to that benevolent agreement who can tell me/remember/commemorate
the slogan of last two command safety week?
No one!! But these command safety weeks are the best platform to initiate a new idea and
implant it to have a culture. So, something is missing in us. That is when we learn something we
don’t share or implement it. Lastly, we don’t take the feedback that much.
So, this time regardless of our rank, age appointment we will focus on only 4 things.
Look for probable hazard,
Report to responsible authority
share your findings and learnings
ask others if they saw anything every day, every week.
Write it down in a computer
Because flight safety is not only a 24/7 job but a benevolent culture. You have to own it, you
have to own it, share it, celebrate it. Only then you will feel like flight safety culture runs through
your veins and will ensure maximum safety in aviation

Case study 1: high oil pressure low oil temp

Case study2: atc mistake