Air transport – OSH issues

Introduction

Air transportation is a large industry: 750 million passengers use the services of European airlines annually, and the number of jobs created directly by the industry was estimated to have reached 1.9 million in 2010.^[1] The jobs can be divided into three main groups: the flight crew, the ground staff airside and the ground staff landside. Many of the workers are exposed to several risks and hazards at their workplace (e.g. time pressure, fatigue, long distance flying, aggressions from clients, dangerous substances, cosmic radiation). This OSH wiki article provides an overview about the hazards and risks in the air transport industry, including flight crew, ground staff airside and ground staff landside. Legal obligations and preventive measures will also be discussed. This article deals with civil air passenger and air cargo transport.

Air transport operations and working conditions

The air transport market in Europe has undergone many significant changes due to air transport liberalisation in Europe. New low cost airlines took advantage of the liberalisation of air services, which led to a wider choice of air services and lower fares. In the EU-15, the number of passengers increased constantly from 1997 to 2006, with an average annual growth of 7 percent. The average number of flights in Europe per day increased from just under 20,000 in 1997 to over 26,000 in 2006.^[2] The increase in air traffic has led to an increase in employment. Due to the liberalisation of ground handling services in air transport (Directive 96/67/EC)^[3], sub-contracting is now common at most airports: airlines outsource ground handling and maintenance, while ground handlers outsource aircraft cleaning. In their Proposal for Regulation of ground handling services, the European Commission stated that ‘the efficient provision of ground handling services is important for airports, airlines and passengers, and is crucial for the efficient use of air transport infrastructure and the performance of the aviation system in general’.^[1]

Subcontracting may have major consequences for occupational safety and health, because subcontracted companies operate simultaneously on site, with different conditions for work organisation and time pressure, as determined by the user company. Coordination of different subcontractors on site is crucial, and the ‘managing body of the airport needs to ensure that these operations are coordinated through an airport Collaborative Decision Making (CDM) and through a proper contingency plan’ ^[4].

The air transport sector has very specific working conditions for the different types of activities in the sector. Activities can be divided into two main groups: flight crew and ground staff. Although the flight crews are the most visible and best known, the vast majority of workers are ground staff. The turnaround of an aircraft requires a complex series of processes, from the moment the aircraft arrives at its gate until it leaves. A large number of workers are involved in the turnaround, making it a complex matter with many different operations.^[5] The staff can be divided in ‘ground staff airside’ and ‘ground staff landside’. The landside areas include gates, terminals, cargo storage areas, parking, and ground access. Airside includes all areas accessible to aircraft, including runways, taxiways and ramps. Access from landside to airside is tightly controlled at most airports.^[6]

A 2005 survey from EUROFOUND shows that, in comparison to other sectors, air transportation workers ^[7]

• work on the weekends more often;
• have more variation in the number of days they work in a week;
• have more variation in starting and finishing time at work;
• work more in alternating/rotating shifts.

Workers in the air transportation sector often work to tight deadlines and under great pressure during airplane turnaround. Table 1 shows the share of workers working to tight deadlines or at high speed in the air transport sector, compared to other sectors.

Table 1: Share of workers whose jobs involve working to tight deadlines or working at very high speed around three quarters of the time or more, ESWC 2005

As a result, workers in the air transport sector experience more problems fitting their working hours with their family and social commitments ^[7].

According to the European Working Conditions Survey, in 2005 about 40% of air transport workers said that they thought their health or safety was at risk because of their work. This is a lot more than in other sectors (27%). The main health problems mentioned are: stress, overall fatigue, backaches, and hearing problems ^[7].

General safety and health hazards in air transport mentioned by the European Agency for Safety and Health (EU OSHA) are: ergonomic risks, work organisational stressors, noise, dangerous substances, vibration, unusual working times, working away from home and from a work base, lack of facilities, and a complex work situation.^[8]

Hazards and risks

Airports and airplanes can be very hazardous environments, and workers in air transport are exposed to a wide variety of hazards and risks. The following chapters give an overview about the most relevant risks and hazards affecting the health and safety of workers in the air transport sector.

Table 2 gives an overview of the wide variety of hazards and risks in air transport.

Table 2: Air transport operators/workers and their occupational risk and hazards – an overview

Source: overview by the author

Work organisational factors

Ground staff

The aircraft turnaround process is critical for airlines, because they are only able to make profit when passengers and cargo are transported. For that reason, all turnaround activities have to be performed in the shortest time possible. This causes time pressure for the workers, leading to negative effects such as: lack of concentration, inadequate decisions, errors, incomplete tasks, and stress. Ground staff experience stress for several reasons: In addition to time pressure, work-related stress factors are: shift work, high work load, gate changes, early or late arrivals, changes in procedure, and equipment malfunction.^[9] Stress affects the performance of the workers and may cause fatigue. According to Michie, situations that are likely to cause stress are those that are unpredictable or uncontrollable, uncertain, ambiguous or unfamiliar, or involving conflict, loss, or performance expectations organisational factors.^[10]

Violence from aggressive passengers is a serious issue for check-in workers. The overbooking policy of some airlines leads to increasing verbal and physical attacks by passengers. A study performed by Rosskam et al. at three Canadian airports showed that one in twenty check-in workers had been physically assaulted on the job, over 80% had been subjected to verbal abuse from passengers, and over 20% had been threatened by passengers.^[11]

Air traffic controllers perform a highly demanding job with a complex series of tasks that require high levels of knowledge and expertise, and high levels of responsibility.^[12] The main risk factors are traffic load peaks, time pressure, shift schedules, night work, unfavourable working conditions, emergency situations, and the lack of control over work.

Flight crew

Flight crew members, including pilots and flight attendants, are exposed to several risks and hazards due to work organisational factors. They work in shifts that involve irregular hours, working weekends and public holidays, and spending time away from home, which adversely affect family responsibilities and leisure activities, and may result in stress and fatigue.

Flight crews flying on long haul flights are exposed to changes in external time, followed by changes in circadian rhythm, which leads to several symptoms known as jet lag. Jet lag and night flight may cause extreme fatigue and thus decreased performance and alertness.

The flight attendants may also experience violence from distressed or dissatisfied passengers. Passengers who behave in a violent or distressed manner can be a serious threat and a hazard to health and safety for cabin and flight crew and other passengers.^[13]

Pilot, co-pilot and flight engineers suffer from high stress levels in their workplace. They perform a highly demanding job that requires high levels of knowledge and expertise, and high levels of responsibility for the safety of many passengers. Operating an aircraft overnight, flying in bad weather or in a high density traffic area, and keeping their flights on-time are the most common causes of high pressure for the cockpit crew.

Physical work factors

Ground staff

The main physical hazards affecting ground staff are exposure to noise and vibrations. The main sources of noise and vibrations from airport operations are aircrafts during landing and take-off, followed by ground operations equipment and vehicles.

According to the German statutory accident insurance for transport (BGF), the noise from aircraft engines, auxiliary power units (APU), ground vehicles, and equipment on the ramp can exceed 85 decibels (dB).^[14] Exposure to noise can cause permanent hearing loss at chronic exposures equal to an average sound pressure level of 85 dB (A) or higher for an eight-hour period.^[15]

Driving vehicles (including fork-lift trucks) or working with ground operations equipment put workers at risk of whole-body vibrations (or parts thereof). Whole-body vibrations are mechanical vibrations transmitted to the body through rump or back in the case of working performed while sitting, or through the feet in the case of work performed while standing. Exposure to high-frequency whole-body vibrations over years may cause balance disorders, visual disturbances, stomach problems, reduced fine motor skills, or affect the spine. Hand-arm vibrations may cause circulation disorders in fingers (e.g. white fingers disease (or hand-arm vibration syndrome), degenerative changes of the hand bones, finger joints and wrists, as well as of the elbow and shoulder regions (Vibration).^[16]

Ground workers operating outside are exposed to adverse weather conditions and lightning hazards. Workers especially at risk of lightning events include those maintaining airport premises (e.g., mowing grass or repairing runway lighting), servicing aircraft on ramps (handling baggage, food service, refuelling, tugging and guiding aircraft from/to gates), and ramp agents.^[17] Since lightning strikes can cause serious injuries or death, it is important to provide timely alerts to airport personnel so that they can get to safety when lightning is imminent.

Workers refuelling the aircraft with jet fuel are at risk of fire and explosion. Maintaining personnel handling explosive substances are also at risk.

Aviation security screeners may be exposed to x-ray while screening carry-on baggage, checked baggage or passengers. A survey performed by NIOSH showed that the radiation doses for baggage screeners were low, suggesting that the shielding on the machines can be effective in limiting worker exposures.^[18] But improper safety equipment as well as improper working practices may lead to an elevated radiation dose. Laser scanners may injure the eyes (Safety of machinery and work equipment).^[19]

Flight crew

The flight crew is also exposed to noise and vibrations resulting from the moving aircraft. Whole-body vibrations occur during the flight, especially when landing and taking off, or during turbulence. Poor seating with improper shock absorption increases the risk of musculoskeletal disorders.^[20]

Working long hours in a pressurised cabin may cause barotrauma during flight. Barotrauma is induced by pressure changes during ascent and descent in aviation, most commonly affecting the middle ear. It occurs when the Eustachian tube is blocked and thus unable to equalize the air pressure in the middle ear with the outside cabin pressure. Barotrauma can be painful, seriously affecting the concentration and working capability of the flight crew.^[21]

Extremely dry cabin air is a further physical hazard for the flight crew. The relative humidity of aircraft varies according Garcia et al (2011) from 25% to less than 2% during the flight. Low moisture in the air may lead to dry skin and eyes, and dry mucous membranes in the nose and throat which can lead to upper respiratory tract infections.^[22]

Cosmic radiation comes from outside the solar system and consists of extremely energetic particles. Most cosmic radiation is adsorbed by the atmosphere. However, doses of cosmic radiation increase with altitude. Flying at higher altitudes common to long-distance flights can expose the flight crew to high levels of cosmic radiation. Flight crews are one of the most exposed professional groups, with annual average exposure at 2.4 millisievert in 2009. According to the German radiation protection monitoring programme, the annual average radiation dose is even higher than for medical staff working in radiology, with an average effective dose under 1.0 millisievert.^[23]

Dangerous substances

Ground staff

Dangerous substances affect workers in transportation in different ways. Exposure to jet fuel exhaust gases is an issue for ground workers, especially airside due to their proximity to airplanes. Jet fuel exhaust is one of the main concerns at an airport, with a potential health impact, particularly on the respiratory tract. The main polluting substances in this environment are nitrogen oxides, carbon dioxide, carbon monoxide, volatile organic compounds (VOCs) including polycyclic aromatic hydrocarbons, sulphur dioxide, and fine and ultrafine particles Workplace exposure to dusts and aerosols - diesel exhaust.^[24]

Cleaners and toilet servicing may come in contact with hazardous cleaning agents and biological agents while draining of the aircraft waste system.

Maintenance workers are exposed to dangerous substances such as oils, lubricants, jet fuel, de-icing fluids, and hydraulic fluids. These substances may be carcinogenic, neurotoxic or sensitizing.

Service workers performing toilet servicing (e.g. draining the aircraft waste system) are exposed to biological hazards. They may inhale aerosols from faeces or may be exposed to skin contact with faeces.

De-icers remove frost, ice, snow or slush from an aircraft by use of a heated aircraft de-icing fluid. Aircraft de-icing fluids are typically composed of ethylene glycol, diethylene glycol or propylene glycol along with water, corrosion inhibitors, wetting agents, thickening agents, and dye that may be hazardous.^[25]

Refuellers may come in contact with Jet A-1 (Kerosene). Hazards associated with skin contact to kerosene over long periods include defatting of the skin, drying, cracking, and possibly dermatitis. Inhalation of mists over a long period may cause chronic inflammatory reaction of the lungs and a form of pulmonary fibrosis Irritants and allergens.^[26]

Flight crew

The flight crew may be occasionally exposed to jet fuel gases. Hazardous substances may enter the cabin air as a result of the bleed air system. Air is drawn from compressors in the engine and mixed with recirculated air from within the cabin that has passed through filters designed to remove bacteria and viruses [51]. Defective engine seals can result in the release of engine oil into the cabin air. These oils contain ingredients such as tricresyl phosphate (TCP). TCP is suspected of causing the aerotoxic syndrome, which is not yet recognised in medicine. However, TCP is only found at very low levels in cabin air. Expert opinion differs on the question of TCP levels in cabin air causing neurological harm ^[27],^[28]

Cabin air may also contain germs and viruses, putting the cabin crew at risk of infection. Disinfection of aircraft cabins is required by a number of countries to reduce the accidental spread of parasites via airline. Flight attendants are exposed to insecticides from spraying or treating the cabin.^[29]

Ebola

Ebola virus disease is a severe, often fatal illness in humans. The average case fatality rate is around 50%. The World Health Organization WHO states that “the current outbreak in west Africa, (first cases notified in March 2014), is the largest and most complex Ebola outbreak since the Ebola virus was first discovered in 1976".^[30] Passengers originating from locations affected by the ongoing Ebola outbreak pose a hazard to workers in the air transport sector. For that reason, the air transport sector is in the centre of attention: workers in air transport may be exposed to Ebola virus. The International Section on Prevention in Transportation published an Ebola factsheet with recommendations for the transport sector.^[31] The CDC has prepared guidance for airline flight crews, cleaning personnel, and cargo operations workers ^[32] and the World Health Organization provides several information and guidelines about Ebola.^[33]

Ergonomic factors

Ground staff

Baggage handlers are at risk of musculoskeletal diseases. They spend long hours on their feet working in awkward body postures, lifting heavy baggage from conveyors to carts and baggage containers for transport to the plane. Lifting heavy baggage can lead to various ergonomic hazards, resulting in injuries.^[34]

Check-in staff also face ergonomic hazards. They often stand at a computer for long periods of time, which may result in fatigue and back pain. They lift heavy baggage onto the conveyor and perform repetitive work.

Flight crew

Flight attendants are at risk of musculoskeletal injuries relating to the shoulder, neck and lower back. The risk is related to the amount of overhead reaching, lifting, pushing, pulling, bending and twisting, and working in awkward body postures.^[35] Areas of risk for musculoskeletal injuries include:

• Handling heavy carry-on baggage
• Overhead reaching required to get to items within the galley and to access the overhead bins
• Poor seating for flight attendants
• Long periods standing
• Bending and squatting required to reach items within the trolleys and galley
• Pulling, pushing and manoeuvring trolleys
• Turbulence
• Confined space
• Aircraft take-off and landing

Accidents

Accidents on airport ramps (aprons)

Airport ramps are unique and potentially hazardous work environments. Servicing, maintaining, and supporting aircraft operations have to be carried out in all kinds of weather, and under time pressure to meet airline schedules. Ramps are busy places of work; noisy and full of vehicles, e.g. passenger buses, mobile lounges, fuel trucks, aircraft tugs, aircraft and baggage tractors, and dolly carts Accident prevention – workplace transport.

Workers face many potential hazards, particularly from the movement and operation of aircraft and ground vehicles. Ramp accidents are one of the biggest problems in the air transport industry. The number of ramp workers injured every year is far higher than for many other industries.^[36] Ramp workers, the flight crew and passengers are all involved in accidents. According to the International Air Transport Association, human error is the primary cause of ramp accidents; 92% of incidents can be traced to a failure to follow procedures, lack of adequate training, and airfield congestion.^[37]

Typically, accidents happen when workers are struck by moving objects or crushed. Slips, trips and falls are caused by obstacles on the ramp such as chocks, ground power units (GPU), cables, tow-bars, bonding cables, fuelling hoses, or spilt liquids.^[38] The most frequent types of injuries are sprains and strains, bruises and contusions, fractures, cuts, laceration, and punctures. Fatal accidents also occur. Aircraft propellers have the potential to cause serious accidents.

Accidents in aircrafts

Aircrafts are hazardous working environments, especially when moving. Flight attendants are exposed to a high-risk of injury through handling heavy baggage, unsafely stored baggage, overhead bins, service trolleys, air stair doors, and through slips, trips and falls. Conditions such as turbulences make the on-board environment more dangerous and are the underlying cause for the majority of the injuries.^[39]

Statistics

Workplace accidents

According to European Statistics on Accidents at work (ESAW), there were 12,481 non-fatal accidents at work in the air transport sector in the EU 28 in 2011. Males accounted for 70% of these accidents (Tab. 3). The data for air transport is not broken up into occupations.

Tab. 3: Non-fatal accidents at work in air transport

Source: Eurostat ESAW^[40]

Not many accident figures are available for this specific sector, although ground workers are exposed to many hazards. More data about workplace accidents and diseases in the air transport industry (especially for ground workers) would help to understand the nature, extent and cost of accidents, and improve safety. The Flight Safety Foundation estimates that 27,000 ramp accidents and incidents occur worldwide every year, injuring about 243,000 people, based on data collected by the International Air Transport Association (IATA).^[1] This corresponds to one accident per 1,000 departures, and an injury rate of 9 per 1,000 departures.^[1] The large number of ground workers using equipment during turnaround under time pressure creates a working environment in which accidents can occur. According to Chamberline et al, accidents during turnaround are likely to occur at the gate stop (43%), at the gate entry and exit area (39%), and outside the ramp entry area (18%). Ground equipment (and, by association, ground workers) are most likely to be involved in ramp operation incidents.^[42]

According to HSE RIDDOR and enforcement statistics for the air transport industry, most accidents are due to handling, slip or trips, moving or falling objects, and moving vehicles [3]. About 40% of all personal injury incidents at airports reported to the Health and Safety Executive in the UK (HSE) are due to Musculoskeletal Disorders (MSD’s) and the majority were reported by ground workers.^[43] A 1995 study found that the most common accidents involved slips, trips and falls, lifting and carrying, and machinery.^[44]

Occupational diseases

Several scientific studies show an increased risk of breast cancer among flight attendants and nurses. The risk of breast cancer for women who have worked at night and in irregular shifts over a long period of time is 1.5 to 1.8 times higher.^[45] In a cohort study among airline cabin attendants performed in eight European countries, breast cancer mortality was slightly but not significantly increased among female cabin crew, whereas mortality from skin cancer (malignant melanoma) was higher in male cabin crew.^[46]

Legal aspects

Directive 89/391 – the OSH "Framework Directive" is the main EU law governing occupational safety and health at work. Under this directive, several so-called daughter directives were adopted General principles of EU OSH legislation. Most of them are relevant for air transport because of the diverse nature of jobs (operations) in this sector. Table 3 lists some important daughter directives.

Table 3: Directives related to safe working in the air transport sector

Source: Compiled by the author

Directive 2000/79/EC - working time. Civil aviation is specific to the situation of the flight personnel. It provides more detailed requirements and minimum standards for organising working time for mobile staff in civil aviation. The working time for ground workers is regulated in Directive 2003/88/EC, laying down minimum safety and health requirements for the organisation of working time. It sets minimum periods of daily rest, weekly rest, annual leave, breaks, and maximum weekly working time. Other important directives regarding aviation safety are Directive 94/56/EC, aiming to facilitate investigations into civil aviation accidents in order to improve air safety, and Directive 2006/23/EC for a community air traffic controller licence.^[47]

The European framework rules for air operations (so-called "EU-OPS"), based on the EU Regulation 1899/2006, were introduced on 16 July 2008. They are detailed in Commission Regulation (EC) No 859/2008.^[48]

The EU-OPS specify minimum safety and related procedures for commercial passenger and cargo fixed wing transport, such as taxi-in, passenger embarking and disembarking, pre-flight check, receipt of passenger information list, receipt of fuel upload, load sheet completion, pushback.^[49]

Regulation (EC) No 216/2008 on common rules in the field of civil aviation, establishing a European Aviation Safety Agency, amended by (EC) No. 1108/2009.^[50]

Prevention and control measures

After the hazards have been identified, the next step is to analyse the work processes and to determine who will be exposed to these hazards and to what extent. This will then lead to the identification of the necessary prevention and control measures, including reassessing the effectiveness of measures already in place. The selection of measures has to follow a certain hierarchy to ensure that the most effective measures like avoidance and substitution are considered first, and the least effective ones such as personal protective equipment are seen as the last resort. It is advisable to involve the workers into this risk assessment process as they have sound knowledge about the conditions and risks at their workplaces. [OSH training| Training] and instructions should be provided for all workers and accompany all types of measures, so workers know and have practiced new methods and processes. Effective risk control may involve a single control measure or a combination of two or more different controls.

Subcontracting may have major consequences for occupational safety and health, because subcontracted companies have to operate simultaneously on site, and the conditions in terms of work organisation and time pressure may be different, as determined by the user company. Coordination of different subcontractors on site is crucial, and the ‘managing body of the airport needs to ensure that these operations are coordinated through an airport Collaborative Decision Making (CDM) and through a proper contingency plan’.^[4]

Examples of prevention measures for different air transport operations with selected hazards and risk are listed in table 4.

Table 4: Examples of prevention measures for selected operations and risk

Source: compiled by the author, adapting ^[23], ^[38], ^[51], ^[52], ^[53], ^[55], ^[56]

Several institutions and insurance associations in Europe have established safety guidelines and training manuals. Some examples are:

The German statutory accident insurance for transport published a series of guidelines for safety and security in air-transport, including: catering, aircraft taxiing/towing, handling jetways, loading, lightning hazards, check-in procedures, and baggage handling. They provide additional information especially for air transport.]^[57]

HSE provides information on its website, including guidelines about aircraft turnaround, assisting disabled passengers, baggage handling, musculoskeletal disorders, and working at heights.^[58]

The Aviation Occupational Health and Safety Steering Group in the UK (AOH&SSG) brings together a range of interested parties that includes airlines, regulators, trade associations, and trade unions. The main objective of the group is to provide a forum with best OHS practices for the aircraft environment.^[59]

The ground safety working group (GSWG) was launched by the European Commercial Aviation Safety Team (ECAST) in 2009. Its aim is to promote and facilitate the adoption of best practices on training for Ground Service Providers (GSP). They have focused on safety culture and human factors emerging in the aircraft turnaround process, proposing a concept called Ramp Resource Management (RRM).^[60]

The European Commercial Aviation Safety Team (ECAST) provides information about safety management and culture.^[61]

The European Aviation Group for Occupational Safety and Health (EAGOSH) is an organisation committed to the promulgation of safe workplaces, safe plant and machinery, safe work procedures and safe people working in the aviation industry.^[62]

The Aviation and Aerospace group of the Institution of Occupational Safety and Health (IOSH) published guidelines and a DVD on airside health and safety instructions.^[38], ^[63]

SKYbrary, a wiki developed by EUROCONTROL, aims to provide a comprehensive source of aviation safety information, available to users worldwide.^[64]