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reports we receive that center on them. Other types of incidents are sufficiently serious so that
even one report would be significant. In International Altimetry, we examine the potential
dangers experienced by flight crews operating in areas where the international altimeter setting
standard (hectopascal) is used—and we have more than one report.
One Zero Ways to Bust an Altitude(Don George) ............................................................. Page 7
Altitude deviations still comprise the majority of ASRS reports, but there seem to be more such
deviations at 10 and 11 thousand feet. Don George discusses some of the likely causes, and some
common sense cures.
What Goes UP…Must Come DOWN(Bill Richards) ........................................................... Page 12
Sometimes the flight crews of aircraft flying at the higher altitudes have a compelling need for
descent without delay. This article (written from a pilot’s standpoint), discusses the implications
for both pilots and controllers, and suggests some methods for handling an immediate descent
from high altitude.
Between a Rockand a Hard Place(Ed Arri) ...................................................................... Page 14
Most of us that fly have experienced the headaches associated with weather avoidance. More
than any other type of report received at the ASRS, weather avoidance incidents are likely to
detail conflict between controllers and flight crews. Ed Arri provides some solid advice for
weather avoidance planning and interaction between pilots and controllers—to avoid ending up
Between a Rock and a Hard Place.
Last Leg Syndrome(Bill Monan) ......................................................................................... Page 19
Do you feel that you aren’t quite as sharp on that last leg of a multi-leg trip? Well, there is a good
chance that you aren’t, and here’s why. This article examines some of the likely reasons for that
last leg letdown, and provides some helpful suggestions for flight crews.
That rounds out this issue of ASRS Directline. To make suggestions for future issues, or just to tell
us what you think about this safety newsletter, fill out and send in the Comments sheet at the end
of this newsletter. (There’s an order form for ASRS Publications and the CALLBACK subscription
too.) We look forward to hearing from you.
— Charles Drew, ASRS Directline Editor
ASRS Directline 3
International
Altimetry by Perry Thomas
T he use of Hecto Pascal or Millibars by some countries has,
on occasion, caused experienced international flight crews (who
are accustomed to inches of mercury) to misset their aircraft
altimeters.
Europe
“[A] three-man, wide-body type aircraft flight
crew experienced in European operations” was
engaged in a difficult (9 degrees drift over
water in heavy rain) VOR–DME approach to
an MDA of 420 feet. The transition altitude
had been 4,000 feet so the experienced, but
weary, flight crew was late receiving ATIS,
reducing the time available for completing
their landing data. QNH was given as
nine-nine-one.
The first officer was flying the approach and
the captain called 1,000 feet MSL in descent.
Shortly thereafter, the second officer called
“300 feet radar altitude—go around!” A missed
approach was flown and the “captain questioned
the tower about altimeter setting…29.91
…this was confirmed. A second voice, however,
corrected that statement to 991 millibars”
[emphasis added].
The aircraft’s altimeters were reset from 29.91
to 991 millibars—a 640 foot difference. The
flight crew later calculated they had come
within 160 feet of hitting the water.
(See the altimeter graphics on page 4.)
Was this merely an isolated incident? Here is
a second occurrence from the other side of the
world.
TheOrient
It was the end of a long overwater flight.
“Approach control gave the altimeter as 998
hectopascal. I read back 29.98. [The] approach
controller repeated his original
statement. Forgetting that our altimeters
have settings for millibars and hectopascal
(which I had only used once in my career,
and that was 6 months ago), I asked where
the conversion chart was. ‘Old hand’ captain
told me that approach [control] meant 29.98.
Assuming that he knew what he was doing,
I believed him. We were a bit low on a
ragged approach and I knew we were
awfully close to some of the hills that dot the
area…but it was not until we landed and
our altimeters read 500 feet low that I
 
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