The Human Factor: Dangerous Distractions

People in aviation are as susceptible to electronic distractions as anyone else.

The impact of people’s fascination with, even addiction to, cell phones and texting is becoming more evident every year. Consider the following:

• A study found that children using cell phones are 43 percent more likely to be hit by a vehicle while crossing the street than children who are not using cell phones.

• A 25 percent increase in pedestrian injuries among 16- to 19-year-olds over the last few years is being attributed to the increase in cell phone use.

• Statistics show that texting and driving is three to four times more dangerous than operating under the influence of alcohol or drugs.

What are some consequences of talking on a cell phone or texting while driving? A man slowly drove his BMW into a ditch while sending an e-mail on a deserted stretch of road. A woman paying bills and sending text messages crashed into a line of stopped vehicles, killing one woman. A flatbed tow truck driver who was texting on one phone as he talked on another crashed into a car, sideswiped a house and ended up in a swimming pool. One of the worst train wrecks in recent history was caused by an engineer who was texting just before the collision and missed critical signals. Other people have walked into light poles and dropped into open manholes — one man even walked into a bear while texting.

What does all this have to do with flying an airplane? Plenty! People in aviation are just as susceptible to distractions, have more opportunities than most people to lose their focus on the most critical areas at the time and suffer more drastic consequences when it happens. For example, a phone conversation was implicated in the Hudson midair collision between a tour helicopter and a Piper Lance that killed nine people. The National Transportation Safety Board report stated the tower controller at the Piper’s departure airport (Teterboro) was “engaged in a bantering personal phone call about a dead cat while directing traffic.” The NTSB report noted that during the time the controller was on the phone, he made several errors. For example, after he made the handoff of the Piper to Newark tower for flight following, he failed to provide the pilot the new frequency for two minutes. When he finally called with the new frequency, he spoke very quickly. The pilot read back an incorrect frequency to the controller, but the controller did not notice the difference.

Because of the traffic over the river, the Newark controller wanted to clear the Piper pilot into the Class B airspace, turn him to the southwest away from the river and clear him to climb to his requested altitude of 3,500 feet. If this had happened in a timely manner, the airplane would not have been on a collision course with the helicopter. As it was, because the pilot was on the wrong frequency, no one could warn him about the impending collision.

Since pilots are not supposed to use cell phones in the cockpit, there are only a few reports of problems caused by cell phones in airplanes. In one case, an ­Airbus A320 captain landing at Singapore left his cell phone on and as they descended through 2,000 feet on approach, he heard numerous alerts as the phone received all the text messages that had been sent while they were out of range of cell towers. The captain retrieved the cell phone, either to read the texts or, as he claimed, to unlock and turn off the phone. In either case, he made numerous errors during this time and finally aborted the landing at 392 feet because the landing gear was not extended.

A similar case in this country almost led to a rejected takeoff. One pilot left his cell phone on and just before reaching V1 during the takeoff, both crew members heard a loud warbling noise that sounded like an alarm. It turned out it was the cell phone’s ring tone. That particular airline did not prohibit crew members from leaving their cell phones on, and the FAA now recommends all airlines review their operation manuals to ensure pilots are required to turn off cell phones prior to departure from the gate.

Probably the most startling example of loss of awareness due to an electronic device involved the two Northwest ­Airlines pilots who flew 150 miles past their destination at Minneapolis while going over schedules using their laptop computers. Delta acquired Northwest the previous year and was in the process of integrating the pilot seniority lists at the two carriers. Although company policy forbids use of laptops in the cockpit for activities not related to the flight, the two very experienced pilots (20,000 hours and 11,000 hours with no accidents, incidents or violations) became engaged in a “heated discussion” about airline scheduling policy to the point that they were no longer monitoring the instruments, keeping track of their location or even aware of calls from ATC.

Even though cell phone or laptop use in the cockpit is not a common problem, pilots experience similar distractions from electronic equipment in the normal execution of their flight duties. Reading information or entering data on a glass cockpit display, flight management system or electronic flight bag is very similar to texting. A recent aviation safety reporting system callback (#392) covered a variety of examples of pilots who lost situational awareness while inputting information or making changes to electronic data in the cockpit:

• A Boeing 737 crew reported they missed a taxiway turn on the last flight of a long duty day. The copilot was finishing inputting weight and balance into the FMS and was not monitoring the route taken by the captain.

• In a similar incident, the copilot of an MD-80 was busy inputting a change of runways into the FMS and did not notice the captain was entering an active runway.

• The captain of a Boeing 767 was taxiing on the ramp toward the taxiway when he felt a shudder and stopped the airplane. The right main gear was partially off the pavement in the grass. The copilot was inputting aircraft communications addressing and reporting system data and receiving the load close out as they taxied out.

• A pilot given a “no-brainer” taxi route with no other aircraft taxiing out decided to take the opportunity to show the pilot in the right seat all the information available on his iPad. As he showed the other pilot the en route charts for the trip, followed by the checklists, he suddenly heard the ground controller shouting for him to “Stop!” He had missed the hold short line and was about to taxi onto the active runway.

A NASA study of crew error accidents and ASRS reports determined at least 34 different types of competing activities preoccupied or distracted pilots, causing them to neglect an important task at a critical moment. More than half of the incidents involved a failure to monitor the current status or position of the aircraft or failure to monitor the actions of the pilot who was flying or taxiing. The researchers determined that most of the 34 activities could be grouped into one of four categories: communications on the radio or between crew members; head-down work, such as programming an FMS or reviewing charts or approach plates; searching for traffic; or responding to abnormal situations.

With the potentially severe consequences of a loss of situational awareness while operating an airplane and the prevalence of distractions throughout a flight, it is critical that all pilots actively work to reduce distractions as much as possible and to respond appropriately when an unavoidable distracting event occurs. The NASA report suggests several “lines of defense” that can reduce the chance of an incident or accident due to distractions:

1. Recognize that conversation is a powerful distracter.

As shown by the numerous accidents caused by people talking or texting on cell phones, it is amazing how distracting conversation is and how easy it is to lose awareness of what is going on around you.

2. Recognize the impact of “head-down tasks” on flying and monitoring.

Even light sport airplanes are being delivered with glass cockpits, leading to a huge temptation in all sizes of airplanes for the pilot to spend his time looking at and programming the system. This can be especially deadly while taxiing, when even a momentary lapse in awareness can put an airplane on an active runway.

3. Suspend noncritical duties when appropriate.

In addition to maintaining a sterile cockpit with no nonoperational conversation while taxiing or below an appropriate altitude, such as 10,000 feet agl, suspend all conversation and head-down tasks at critical points in the flight, such as approaching an active runway, a level-off altitude or a turn.

4. Treat interruptions as red flags.

Whether it is as simple as a call from ATC while running a checklist or as complicated as a serious passenger issue, recognize any interruption as a significant opportunity for error, note what you were doing at the time of the interruption and make a conscious effort to maintain your overall awareness as you deal with the distraction and as you return to your normal duties.

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