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examinations. When seating plans are not available and when local or national authorities removed bodies
but did not record their location, clues may often be discovered as to the seating of passengers; for example,
a book or handbag found in the compartment on a seat back will suggest a probable location of its owner.
Fragments of fabric, fused to aircraft structure, compared with clothing removed from bodies may permit
deductions about the location of bodies - at least where the bodies came to rest, if not their seat locations.
ICAO Preliminary Unedited Version — October 2008 IV-1-16
OTHER MEDICAL ASPECTS OF THE HUMAN
FACTORS INVESTIGATIONS
Flight crew medical and personal records -
Basic mental and physical health
The medical records of the flight crew must be studied to find out whether any condition was known to exist
which might have precluded the successful completion of the demanded task in the prevailing
circumstances. Particular attention should be given to any condition likely to have led to incapacitation in
flight or to a deterioration in fitness and performance. The possible cause of incapacitation or lowered
efficiency of performance is, theoretically, the range of the diseases of man but, with adequate medical
supervision of crews, gross abnormalities are unlikely to be present.
Any information obtained from the medical records must be correlated with the pathological findings.
Many functional abnormalities, however, are not demonstrable at autopsy - epilepsy being the prime
example. Visual and auditory acuity of the crew should also be noted but, again, it will be the essentially
negative pathological findings in an accident suspected of having a human factor cause that will focus
attention on these systems.
In certain circumstances, the flight crew background should be investigated and this will include
consideration of such matters as motivation for flying, general intelligence, emotional stability, character
and behaviour. However, well-documented abnormalities of this sort are scarcely compatible with modern
flight crew selection methods or effective working as part of an airline operation. It may be that information
obtained from friends, relatives, acquaintances, supervisors, instructors, personal physicians and other
observers as to both the recent activities and attitudes of the flight crew and to their long-term personal and
flying habits, general health and ordinary behaviour may provide information which is of far greater value.
This has been called a psychological autopsy (see further reading list).
The recognition and investigation of the psycho-physiological elements underlying many accident causes
have not always been given the proper degree of attention. Human elements of perception, judgement,
decision, morale, motivation, ageing, fatigue, and incapacitation are often relatively intangible, yet highly
pertinent variables. Even when detected, they are difficult to measure and document. It should be
emphasized that a positive association between any such abnormality discovered and the cause of the
accident can seldom, if ever, be better than conjecture. Despite these difficulties, every effort must be made
to investigate and report upon such human factors as fully as possible. It may be necessary to include a
psychologist familiar with aviation in the Human Factors Group.
The problems of a particular flight
Many matters that are not of a medical nature may be pertinent to the Human Factors Group and it is here
that a close liaison with the Operations Group is essential.
Some of the general problems of this type include:
a) the flight plan - with particular reference to instructions given and deviations made from those
instructions;
b) the flight equipment - ranging from items such as the aircraft type, to cockpit layout, mechanisms
for cabin pressurization, ventilation and temperature control;
c) the navigation aids - particularly whether they were used to their full extent;
ICAO Preliminary Unedited Version — October 2008 IV-1-17
d) the flight environment and flight phase - which should include a consideration of the possible
presence of fumes from the engine fluids and fuel and also of toxic substances from the cargo;
e) assessment of the workload of the crew at the time of the accident.
The importance of this information to the Human Factors Group is essentially to guide them into
significant areas of investigation on their own account. For example, a deviation from the flight path might
suggest a need for an examination for carbon monoxide intoxication; a suspect pressurization system might
indicate a need to confirm or exclude hypoxia as a cause of the accident. The itemization of likely toxic
causes will simplify and direct the work of the toxicologist. These are the sort of matters that emphasize the
　
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