Haryono, Aloysius Sigit and Sofianti, Tanika D. and Hendriana, Dena (2021) Application of Human Factors Analysis and Intervention in Structuring KNKT’s Recommendations: A Case Study of Wamena Airport Air Accidents. Masters thesis, Swiss German University.

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Abstract

Wamena airport experienced accidents in 2002, 2008, 2009, 2013, 2015, and 2016. All accidents were cargo flights and in approach and landing flight phases. As the Swiss Cheese concept accident happened when errors penetrated safety defenses’ layers in straight line. Structuring KNKT’s investigations, under HFACS framework to understand the human factor failures type and HFIX strategy to close the failures by applying the recommendations, need to be done in air accident investigation. Prioritizing the implementation’s recommendations using AHP, eleven aviation experts and practitioners were questioned in this study, when failure intervened by two or more interventions. There were layers without any failures in accident 2008, 2013, and 2016. Accident in 2016 has no recommendation due operators’ safety actions were considered relevant to block failures. Accidents in 2002, 2009, 2013, and 2015 have failure which intervened by two or more recommendations and AHP was used to prioritize the intervention. There were failures remain open in accident 2002, 2009, 2013, and 2016. Repetitive failure of repetitive accidents in 2002, 2009, 2013, 2015, and 2016 is un-stabilized approach and has not been blocked with effective interventions. HFACS and HFIX are useful to framework the accident investigation, preventing similar accident happened in the future.

Item Type:	Thesis (Masters)
Uncontrolled Keywords:	HFACS, Swiss Cheese, HFIX, AHP, Un-Stabilized Approach.
Subjects:	H Social Sciences > HE Transportation and Communications > HE9761 Air transportation. Airlines N Fine Arts > NA Architecture > NA6300 Airport terminals T Technology > TJ Mechanical engineering and machinery T Technology > TJ Mechanical engineering and machinery > TJ163.12 Mechatronics
Depositing User:	Faisal Ifzaldi
Date Deposited:	19 Aug 2021 11:03
Last Modified:	19 Aug 2021 11:03
URI:	http://repository.sgu.ac.id/id/eprint/2151

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