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Air safety is a broad term encompassing the theory, investigation and categorization of flight failures, and the prevention of such failures through appropriate regulation, as well as through education and training. It can also be applied in the context of campaigns that inform the public as to the safety of air travel. No matter the speed and economy of any mode of transportation, if it is not perceived and demonstrated as safe, it will find few customers and, with few customers, unless it can still be priced to make a profit, the transportation mode will fail and fade from the scene. The dirigibles of the 1920s and '30s provide a good example of this principle.

Balanced against the speed of travel and the convenience of schedule, transportation by air must overcome various phobias of much of the traveling public: fear of heights, enclosed spaces, surrender of control. Human phobias are not a factor with cargo shipments, but if the shipment doesn't arrive safely, the air carrier will find few customers seeking its service.

Air accidents tend to make national, even international, news. In major airliner accidents, hundreds of passengers may be affected. Add to this the number of family members who will be available at the airports at either end of the flight, ready for interviews, providing pictures of anguish on television news and the task before the industry becomes plain.

Therefore, the entire industry and the government bodies who regulate and support it put a great deal of effort into making air transportation not only appear safe, but demonstrating that it is the safest mode of transportation available.

Controlled impact demonstration dummies

NASA air safety experiment (CID project)

Institutions[]

Certification[]

In most countries, civil aircraft have to be certified by the civil aviation authority (CAA) to be allowed to fly. The major aviation authorities worldwide are the US Federal Aviation Administration (FAA) the European Aviation Safety Agency (EASA) (which provides regulatory advice to the European Union and to a degree supplanted the regulatory bodies of member countries) and the Joint Aviation Authorities (JAA) which advises the CAAs that are members of the European Civil Aviation Conference). FAA, EASA and JAA collaborate on many issues, especially in order to provide streamlined procedure and avoid conflicting or duplicate requirements. FAA and EASA are, in particular, primarily responsible for the certification of the airliners from the two major manufacturers Boeing and Airbus.

Aircraft are certified against standards set out in the code for each CAA. Those codes are very similar and differ primarily in equipment and environmental standards. Regulations on maintenance, repair and operation provide further direction to the owners of the aircraft so that the aircraft continues to meet design standards.

United States[]

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During the 1920s, the first laws were passed in the USA to regulate civil aviation. Of particular significance was the Air Commerce Act 1926, which required pilots and aircraft to be examined and licensed, for accidents to be properly investigated, and for the establishment of safety rules and navigation aids, under the Aeronautics Branch of the Department of Commerce.

Despite this, in 1926 and 1927 there were a total of 24 fatal commercial airline crashes, a further 16 in 1928, and 51 in 1929 (killing 61 people), which remains the worst year on record at an accident rate of about 1 for every 1,000,000 miles flown. Based on the current numbers flying, this would equate to 7,000 fatal incidents per year.

The fatal incident rate has declined steadily ever since, and, since 1997 the number of fatal air accidents has been no more than 1 for every 2,000,000,000 person-miles flown (e.g., 100 people flying a plane for 1000 miles counts as 100,000 person-miles, making it comparable with methods of transportation with different numbers of passengers, such as one person driving a car for 100,000 miles, which is also 100,000 person-miles), making it one of the safest modes of transport.

Another aspect of safety is protection from attack (discussed below). The terrorist attacks of 2001 are not counted as accidents. However, even if they were counted as accidents they would have added only about 2 deaths per 2,000,000,000 person-miles. Unfortunately, only 2 months later, American Airlines Flight 587 crashed in Queens, NY, killing 256 people, including 5 on the ground, causing 2001 to have a very high fatality rate. Even so, the rate that year including the attacks (estimated here to be about 4 deaths per 1,000,000,000 person-miles), may be relatively safe compared to some other forms of transport.

Safety improvements have resulted from a wide variety of factors, including improved aircraft design, engineering and maintenance, the evolution of navigation aids, and safety protocols and procedures.

It is often reported that air travel is the safest in terms of deaths per passenger mile. The National Transportation Safety Board (2006) reports 1.3 deaths per hundred million vehicle miles for travel by car, and 1.7 deaths per hundred million vehicle miles for travel by air [1]. These are not passenger miles. If an airplane has 100 passengers, then the passenger miles are 100 times higher, making the risk 100 times lower. The number of deaths per passenger mile on commercial airlines between 1995 and 2000 is about 3 deaths per 10 billion passenger miles [2].

Navigation aids[]

One of the first navigation aids to be introduced (in the USA in the late 1920s) was airfield lighting to assist pilots to make landings in poor weather or after dark. The Precision Approach Path Indicator was developed from this in the 1930s, indicating to the pilot the angle of descent to the airfield. This later became adopted internationally through the standards of the International Civil Aviation Organization (ICAO).

With the spread of radio technology, several experimental radio based navigation aids were developed from the late 1920s onwards. These were most successfully used in conjunction with instruments in the cockpit in the form of Instrument Landing Systems (ILS), first used by a scheduled flight to make a landing in a snowstorm at Pittsburgh in 1938. A form of ILS was adopted by the ICAO for international use in 1949.

Following the development of radar in World War II, it was deployed as a landing aid for civil aviation in the form of Ground Control Approach (GCA) systems, joined in 1948 by Distance Measuring Equipment (DME), and in the 1950s by airport surveillance radar as an aid to air traffic control. VHF omnidirectional range (VOR) became the predominate means of route navigation during the 1960s. The ground based VOR stations were often combined with DME at the same site, so that pilots could know both their radials in degrees w.r.t. north to, and their slant range distance to, that beacon [3].

All of the ground-based navigation aids are rapidly being supplemented by satellite-based aids like GPS, which make it possible for aircrews to know their position with great precision anywhere in the world. With the arrival of Wide Area Augmentation System (WAAS), GPS navigation has become accurate enough for vertical (altitude) as well as horizontal use, and is being used increasingly for instrument approaches as well as en-route navigation. However, since the GPS constellation is a single-point of failure that can be switched off by the U.S. military in time of crisis, ground-based navigation aids are still required for backup.

Air safety topics[]

Lightning[]

Boeing studies have shown that airliners are struck by lightning on average of twice per year. While the "flash and bang" can be dramatic and startling to the passengers and crew, aircraft are able to withstand normal lightning strikes.

The dangers of more powerful positive lightning were not understood until the destruction of a glider in 1999 [4]. It has since been suggested that positive lightning may have caused the crash of Pan Am Flight 214 in 1963. At that time aircraft were not designed to withstand such strikes, since their existence was unknown at the time standards were set.

The effects of normal lightning on traditional metal-covered aircraft are well understood and serious damage from a lightning strike on an airplane is rare. However, as more and more aircraft, like the upcoming Boeing 787, whose whole exterior is made of non-conducting composite materials take to the skies, additional design effort and testing must be made before certification authorities will permit these aircraft in commercial service.

Ice and snow[]

Snowy and icy conditions are frequent contributors to airline accidents. The December 8, 2005 accident where Southwest Airlines Flight 1248 slid off the end of the runway in heavy snow conditions is just one of many examples. Just as on a road, ice and snow buildup can make braking and steering difficult or impossible if severe enough.

The icing of wings is another common problem that is well known and measures have been developed to combat it. The greatest concern regarding icing is that even a small amount of ice or coarse frost can greatly decrease the ability of a wing to develop lift. This could prevent an otherwise capable aircraft from safely taking off. If ice builds up during flight the result can be catastrophic as evidenced by the crash of American Eagle Flight 4184 (an ATR-72 aircraft) near Roselawn, Indiana on October 31 1994, killing 68, or Air Florida Flight 90. [5]

Airlines and airports expend considerable effort to ensure that aircraft are properly de-iced before takeoff whenever the weather threatens to create icing conditions. Modern airliners are designed to prevent ice buildup on wings, engines, and tails by either routing heated air from jet engines through the leading edges of the wing, tail, and inlets, or on slower aircraft, by use of inflatable rubber "boots" that expand and break off any accumulated ice.

Finally, airline dispatch offices keep close watch on weather along the routes of their flights, helping the pilots avoid the worst of possible inflight icing conditions. Pilots can also be equipped with an ice detector in order to leave icy areas they have inadvertently flown into.

Engine failure[]

Although aircraft are now designed to fly even after the failure of one or more aircraft engines, the failure of the second engine on one side for example is obviously serious. Losing all engine power is even more serious, as illustrated by the 1970 Dominicana DC-9 air disaster, when fuel contamination caused the failure of both engines. To have an emergency landing place is then very important.

In the 1983 Gimli Glider incident, an Air Canada flight suffered fuel exhaustion during cruise flight, forcing the pilot to glide the plane to an emergency deadstick landing. The automatic deployment of the Ram Air Turbine maintained the necessary hydraulic pressure to the flight controls, so that the pilot was able to land with only a minimal amount of damage to the plane, and minor (evacuation) injuries to a few passengers.

The ultimate form of engine failure, physical separation, occurred in 1979 when a complete engine detached from American Airlines Flight 191, causing damage to the aircraft from which the pilots were unable to recover.

Metal fatigue[]

Metal fatigue has occasionally caused failure either of the engine (for example in the 1989 Kegworth Air Disaster), or of the aircraft body, for example the De Havilland Comets in 1953 and 1954 and Aloha Flight 243 in 1988. Now that the subject is better understood, rigorous inspection and nondestructive testing procedures are in place to attempt to identify potential problems.

Delamination[]

Composite materials consist of layers of fibers embedded in a resin matrix. In some cases, especially when subjected to cyclic stress, the fibers may tear off the matrix, the layers of the material then separate from each other - a process called delamination, and form a mica-like structure which then falls apart. As the failure develops inside the material, nothing is shown on the surface; instrument methods (often ultrasound-based) have to be used.

Numerous modern aircraft have developed delamination problems, but most were discovered before they caused a catastrophic failure. Delamination risk is as old as composite material. Even in the 1940s, several Yak-9s experienced delamination of plywood in their construction.


Stalling[]

Stalling an aircraft (increasing the angle of attack to a point at which the wings fail to produce enough lift) is a potential danger, but is normally recoverable. Certain devices have been developed to warn the pilot as stall approaches. These include stall warning horns (now standard on virtually all powered aircraft), stick shakers and voice warnings. Two well known stall-related airline accidents, were the Staines air disaster in 1972, and the United Airlines Flight 553 crash, while on approach to Chicago Midway International Airport, also in 1972.

Fire[]

Safety regulations control aircraft materials and the requirements for automated fire safety systems. Usually these requirements take the form of required tests. The tests measure flammability and the toxicity of smoke. When the tests fail, they fail on a prototype in an engineering laboratory, rather than in an aircraft.

Fire on board the aircraft, and more especially the toxic smoke generated, have been the cause of several incidents. An electrical fire on Air Canada Flight 797 in 1983 caused the deaths of 23 of the 46 passengers, resulting in the introduction of floor level lighting to assist people to evacuate a smoke-filled aircraft. Two years later a fire on the runway caused the loss of 53 lives, 48 from the effects of smoke, in the 1985 Manchester air disaster. This incident raised serious concerns over the standard aircraft emergency evacuation time of ninety seconds, and calls for the introduction of smoke hoods or misting systems although both were rejected. It did result in the introduction of revised overwing emergency exit doors on certain new aircraft, and a small increase in the spacing between seats next to the emergency exit.

The cargo holds of most airliners are equipped with "fire bottles" (essentially remote-controlled fire extinguishers) to combat a fire that might occur in with the baggage and freight below the passenger cabin. This was due to a terrible accident in 1996. In May of that year a ValuJet DC-9 crashed into the Florida Everglades a few minutes after takeoff after a fire broke out in the forward cargo hold. All 110 aboard were killed.

The investigation determined that improperly packaged chemical oxygen generators (used for the drop-down oxygen masks in the aircraft cabin) had been loaded into the cargo hold. Oxygen generators produce oxygen through a chemical reaction that also generates hundreds of degrees of heat. When installed for use in the ceiling above the passenger seats they are surrounded by heat-resistant shielding and present no fire hazard. On this flight they had been put loosely into a cardboard box for shipment from a maintenance facility. It is likely that one or more of the generators ignited, during or immediately after takeoff, producing an oxygen-rich environment. The cardboard box containing the generators would have quickly caught fire from the heat of the ignited generator. The fire spread to an aircraft tire that was also carried in the hold. Ordinarily the fire would have smothered itself, because of the airtight design of that cargo compartment. But the oxygen generators kept feeding oxygen to the fire, defeating the smothering design of the DC-9 cargo hold. The fire rapidly burned through the passenger cabin floor, incapacitating all aboard with smoke and poisonous gases very quickly. The pilots, although having smoke masks and separate oxygen supplies, had no hope of maintaining control as control cables and electrical wiring burned through.

The maintenance facility (SabreTech) was subjected to large fines and ValuJet, due to this accident and other irregularities, was grounded. The airline reemerged as a smaller airline and eventually merged with AirTran, a smaller carrier. Adopting the acquired airline's name, the airline has since provided safe service. For the airline industry, rules for the shipment of oxygen generators was severely restricted and cargo holds on larger airliners were required to have "fire bottles" installed.

At one time firefighting foam paths were laid down before an emergency landing, but the practice was considered only marginally effective, and concerns about the depletion of firefighting capability due to pre-foaming led the United States FAA to withdraw its recommendation in 1987.

Bird strike[]

Bird strike is an aviation term for a collision between a bird and an aircraft. It is a common threat to aircraft safety and has caused a number of fatal accidents. In 1988 an Ethiopian Airlines Boeing 737 sucked pigeons into both engines during take-off and then crashed in an attempt to return to the Bahir Dar airport; of the 104 people aboard, 35 died and 21 were injured. In another incident in 1995, a Dassault Falcon 20 crashed at a Paris airport during an emergency landing attempt after sucking lapwings into an engine, which caused an engine failure and a fire in the airplane fuselage; all 10 people on board were killed. [6]

Modern jet engines have the capability of surviving an ingestion of a bird. Small fast planes, such as military jet fighters, are at higher risk than big heavy multi-engine ones. This is due to the fact that the fan of a high-bypass turbofan engine, typical on transport aircraft, acts as a centrifugal separator to force ingested materials (birds, ice, etc.) to the outside of the fan's disc. As a result, such materials go through the relatively unobstructed bypass duct, rather than through the core of the engine, which contains the smaller and more delicate compressor blades. Military aircraft designed for high-speed flight typically have pure turbojet, or low-bypass turbofan engines, increasing the risk that ingested materials will get into the core of the engine to cause damage.

The highest risk of the bird strike is during the takeoff and landing, in low altitudes, which is in the vicinity of the airports. Some airports use active countermeasures, ranging from a person with a shotgun through recorded sounds of predators to employing falconers. Poisonous grass can be planted that is not palatable to birds, nor to insects that attract insectivorous birds. Passive countermeasures involve sensible land-use management, avoiding conditions attracting flocks of birds to the area (eg. landfills). Another tactic found effective is to let the grass at the airfield grow taller (approximately 12") as some species of birds won't land if they cannot see one another.

Ground damage[]

Aircraft are often victims of damage caused by ground equipment at the airport. In the act of servicing the aircraft between flights a great deal of ground equipment must operate in close proximity to the fuselage and wings. Occasionally the aircraft gets bumped or worse.

Damage may be in the form of simple scratches in the paint or small dents in the skin. However, because aircraft structures (including the outer skin) play such a critical role in the safe operation of a flight, all damage is inspected, measured and possibly tested to ensure that any damage is within safe tolerances. A dent that may look no worse than common "parking lot damage" to an automobile can be serious enough to ground an airplane until a repair can be made.

An example of the seriousness of this problem was the December 26, 2005 depressurization incident on an Alaska Airlines MD-83 aircraft. During ground services a ramp worker hit the side of the aircraft with a piece of ground equipment. This created a crease in the metal skin. This damage was not reported and the plane departed. Climbing through 26,000 feet the crease in the metal gave way due to the growing difference in pressure between the inside of the aircraft and the outside air. The cabin depressurized with a bang, frightening all aboard and necessitating a rapid descent back to denser (breathable) air and an emergency landing.

The three pieces of ground equipment that most frequently damage aircraft are the passenger boarding bridge, catering trucks, and cargo "beltloaders'. However, any other equipment found on an airport ramp can damage an aircraft through careless use, high winds, mechanical failure, and so on.

The generic industry colloquial term for this damage is "ramp rash."

Volcanic ash[]

Plumes of volcanic ash near active volcanoes present a risk especially for night flights. The ash is hard and abrasive and can quickly cause significant wear on the propellers and turbocompressor blades, and scratch the cabin windows, impairing visibility. It contaminates fuel and water systems, can jam gears, and can cause a flameout of the engines. Its particles have low melting point, so they melt in the combustion chamber and the ceramic mass then sticks on the turbine blades, fuel nozzles, and the combustors, which can lead to a total engine failure. It can get inside the cabin and contaminate everything there, and can damage the airplane electronics. [7]

There are many instances of damage to jet aircraft from ash encounters. In one of them in 1982, a British Airways Boeing 747 flew through an ash cloud, lost all four engines, and descended from 36,000 feet to only 12,000 feet before the flight crew managed to restart the engines.

With the growing density of air traffic, encounters like this are becoming more common. In 1991 the aviation industry decided to set up Volcanic Ash Advisory Centers (VAACs), one for each of 9 regions of the world, acting as liaisons between meteorologists, volcanologists, and the aviation industry. [8]


Human factors[]

See also aviation medicine

CID slapdown

NASA air safety experiment. The airplane is a Boeing 720 testing a new form of jet fuel.

Human factors including pilot error are another potential danger, and currently the most common factor of aviation crashes. Much progress in applying human factors to improving aviation safety was made around the time of World War II by people such as Paul Fitts and Alphonse Chapanis. However, there has been progress in safety throughout the history of aviation, such as the development of the pilot's checklist in 1937 [9]. Pilot error and improper communication are often factors in the collision of aircraft. This can take place in the air (1978 PSA Flight 182) or on the ground (1977 Tenerife disaster). The ability of the flight crew to maintain situation awareness is a critical human factor in air safety.

Failure of the pilots to properly monitor the flight instruments resulted in the crash of Eastern Air Lines Flight 401 in 1972, and error during take-off and landing can have catastrophic consequences, for example cause the crash of Prinair Flight 191 on landing, which also in 1972.

Rarely, flight crew members are arrested or subject to disciplinary action for being intoxicated on the job. In 1990, three Northwest Airlines crew members were sentenced to jail for flying from Fargo, North Dakota to Minneapolis-St. Paul International Airport while drunk. In 2001, Northwest fired a pilot who failed a breathalyzer test after flying from San Antonio, Texas to Minneapolis-St. Paul. In July 2002, two America West pilots were arrested just before they were scheduled to fly from Miami, Florida to Phoenix, Arizona because they had been drinking alcohol. The pilots have been fired from America West and the FAA revoked their pilot's licenses. As of 2005 they await trial in a Florida court [10]. The incident created a public relations problem and America West has become the object of many jokes about drunk pilots. While these drunk-flying incidents did not result in crashes, they underscore the role that poor human choices can play in air accidents.

Human factors incidents are not limited to errors by the pilots. The failure to close a cargo door properly on Turkish Airlines Flight 981 in 1974 resulted in the loss of the aircraft - however the design of the cargo door latch was also a major factor in the incident. In the case of Japan Airlines Flight 123, improper maintenance resulted in the loss of the vertical stabilizer.

Controlled flight into terrain (CFIT) is a class of accident in which an undamaged aircraft is flown, under control, into terrain. CFIT accidents typically are a result of pilot error or of navigational system error. Some pilots, convinced that advanced electronic navigation systems such as GPS and INS coupled with Flight Management System computers , or over-relianced on them, are partially responsible for these accidents, have called CFIT accidents "computerized flight into terrain". Failure to protect Instrument Landing System critical areas can also cause controlled flight into terrain. Crew awareness and monitoring of navigational systems can prevent or eliminate CFIT accidents. Crew Resource Management is a modern method now widely used to improve the human factors of air safety. The Aviation Safety Reporting System, or ASRS is another.

Other technical aids can be used to help pilots maintain situational awareness. A ground-collision warning system is an on-board system that will alert a pilot if the aircraft is about to fly into the ground. Also, air traffic controllers constantly monitor flights from the ground and at airports.

Terrorism can also be considered a human factor. Crews are normally trained to handle hijack situations. Prior to the September 11, 2001 attacks, hijackings involved hostage negotiations. After the September 11, 2001 attacks, stricter measures are in place to prevent terrorism using passenger screening technology, air marshals, and precautionary policies. In addition, counter-terrorist organizations monitor potential terrorist activity.

Although most air crews are screened for psychological fitness, some may take suicidal actions. In the case of EgyptAir Flight 990, it appears that the first officer (co-pilot) deliberately dove his aircraft into the Atlantic Ocean while the captain was away from his station, in 1999 off Nantucket, MA, USA. Motivations are unclear, but recorded inputs from the black boxes showed no mechanical problem, no other aircraft in the area, and was corroborated by the voice cockpit recorder.

The use of certain electronic equipment is partially or entirely prohibited as it may interfere with aircraft operation, such as causing compass deviations. Use of personal electronic devices and calculators may be prohibited when an aircraft is taking off or landing. The American FCC prohibits the use of a cell phone on most flights, because in-flight usage creates problems with ground-based cells. There is also concern about possible interference with aircraft navigation systems, although that has never been proven to be a non-serious risk on airliners. A few flights now allow use of cell phones, where the aircraft have been specially wired and certified to meet both FAA and FCC regulations.

Airport design[]

Airport design and location can have a big impact on air safety, especially since some airports such as Chicago Midway International Airport were originally built for propeller planes and many airports are in congested areas where it is difficult to meet newer safety standards. For instance, the FAA issued rules in 1999 calling for a Runway Safety Area, usually extending 500 feet to each side and 1000 feet beyond the end of a runway. This is intended to cover ninety percent of the cases of an aircraft leaving the runway by providing a buffer space free of obstacles. Since this is a recent rule, many airports do not meet it. One method of substituting for the 1000 feet at the end of a runway for airports in congested areas is to install an Engineered Materials Arrestor System, or EMAS. These systems are usually made of a lightweight, crushable concrete that absorbs the energy of the aircraft to bring it to a rapid stop. They have stopped three aircraft (as of 2005) at JFK Airport.

Infection[]

In considering that on an aeroplane, hundreds of people sitting in a confined space for extended periods of time should result in the ready transmission of airborne infections should not come as a surprise.[1][2] For this reason, airlines place restrictions on the travel of passengers with known airborne contagious diseases (e.g., tuberculosis). During the SARS epidemic of 2003, awareness of the possibility of acquisition of infection on a commercial aircraft reached it zenith when on one flight from Hongkong to Beijing, 16 of 120 people on the flight developed proven SARS from a single index case.[3]

There is very limited research ( and this has been edited) done on contagious diseases on aircraft. The two most common respiratory pathogens to which air passengers are exposed are parainfluenza and influenza.[4] Certainly, the flight ban imposed following the attacks of September 11, 2001 restricted the ability influenza to spread around the globe, resulting in a much milder influenza season that year,[5] and the ability of influenza to spread on aircraft has been well documented.[1] There is no data on the relative contributions of large droplets, small particles, close contact, surface contamination, and certainly no data on the relative importance of any of these methods of transmission for specific diseases, and therefore very little information on how to control the risk of infection. There is no standardisation of air handling by aircraft, installation of HEPA filters or of hand washing by air crew, and no published information on the relative efficacy of any of these interventions in reducing the spread of infection.[6]

Accidents and incidents[]

Investigators[]

  • Air Accidents Investigation Branch (UK)
  • National Transportation Safety Board (USA)
  • Transportation Safety Board (Canada)
  • Bundesstelle für Flugunfalluntersuchung (Germany)
  • Bureau d'Enquêtes et d'Analyses pour la sécurité de l'Aviation Civile (France)
  • Australian Transport Safety Bureau (Australia)
  • Air Accident Investigation Unit (Ireland) http://www.aaiu.ie/
  • Aircraft and Railway Accidents Investigation Commission (Japan)

Regulation[]

  • Federal Aviation Administration
    • Federal Aviation Regulations
  • Joint Aviation Authorities
  • United Kingdom Civil Aviation Authority
  • Irish Aviation Authority - http://www.iaa.ie/
  • Transportation Safety Board of Canada

See also[]

External links[]

Footnotes[]

  1. 1.0 1.1 Mangili A, Gendreau MA (2005). Transmission of infectious diseases during commercial air travel. Lancet 365: 989–96. PMID 15767002.
  2. Leder K, Newman D (2005). Respiratory infections during air travel. Intern Med J 35. PMID 15667469.
  3. Olsen SJ, Chang HL, Cheung TY, et al. (2003). Transmission of the severe acute respiratory syndrome on aircraft. N Engl J Med 349: 2416–22. PMID 14681507.
  4. Luna LK, Panning M, Grywna K, Pfefferle S, Drosten C (2007). Spectrum of viruses and atypical bacteria in intercontinental air travelers with symptoms of acute respiratory infection. J Infect Dis 195: 675–9. PMID 17262708.
  5. Brownstein JS, Wolfe CJ, Mandl KD (2006). Empirical evidence for the effect of airline travel on inter-regional influenza spread in the United States. PLoS Med 3: 3401. PMID 16968115.
  6. Pavia AT (2007). Germs on a Plane: Aircraft, International Travel, and the Global Spread of Disease. J Infect Dis 195: 621–22.
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