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personal fatigue;
3) prolonged cold that affects the sense of touch or smell;
4) humidity or rain that affects aircraft, part or tool surfaces, including use of paper documents;
5) precipitation affecting visibility or necessitating bulky protective clothing;
6) insufficient lighting for reading instructions or placards, conducting visual inspections or
performing tasks;
7) wind affecting ability to hear or communicate, or irritating eyes, ears, nose or throat;
8) vibrations making instrument reading difficult or inducing fatigue in hands or arms;
9) cleanliness affecting ability to perform visual inspections, compromising footing or grip, or
reducing available workspace;
10) hazardous or toxic substances affecting sensory acuity, causing headaches, dizziness or other
discomfort, or requiring wearing of awkward protective clothing;
11) power sources that are inadequately protected or marked;
12) inadequate ventilation causing personal discomfort or fatigue; and
13) workspace too crowded or inefficiently organized.
h) Organizational factors. This category includes such factors as internal communication with support
organizations, the level of trust that is established between management and AMEs, awareness and
buy-in to management’s goals, and union activities. All these factors can affect the quality of work —
and therefore the scope for maintenance error. The following are some of the organizational factors
that MEDA identifies as being potentially contributory to maintenance errors:
1) quality of support from technical organizations that is inconsistent, late or otherwise poor;
2) company policies that are unfair or inconsistent in their application, inflexible in considering
special circumstances, etc.;
3) company work processes, including inappropriate SOPs, inadequate work inspections and
outdated manuals;
Chapter 19. Aircraft Maintenance
Appendix 2 19-APP 2-5
4) union action that becomes a distraction; and
5) corporate change (e.g. restructuring) creating uncertainty, relocations, layoffs, demotions, etc.
i) Leadership and supervision. This category is tightly linked to the category on organizational
factors. Although supervisors do not normally perform the maintenance tasks, they can contribute to
maintenance errors through poor planning, prioritizing and organizing of job tasks. Supervisors and
management must provide a vision of where the maintenance function is headed and how it is going
to get there; in their daily activities they must “walk the talk”, i.e. their acts must match their words.
Some areas where weaknesses in leadership and supervision can create a work environment
conducive to maintenance errors include:
1) inadequate planning or organization of tasks affecting the availability of time or resources to
complete work properly;
2) inadequate prioritization of work;
3) inadequate delegation or assignment of tasks;
4) unrealistic attitude or expectations leading to inadequate time to complete the job;
5) excessive or inappropriate supervisory style, second-guessing AMEs or failing to involve them in
decisions affecting them; and
6) excessive or aimless meetings.
j) Communication. This category refers to any breakdown in (written or oral) communication that
prevents the AME from getting the correct information regarding a maintenance task in a timely
manner. Listed below are some MEDA examples of interfaces between employees where
breakdowns in communication occur, thereby creating the potential for maintenance errors:
1) Between departments — vague or incomplete written directions, incorrect routing of information,
personality conflicts, or failure to pass on timely information;
2) Between AMEs — failure to communicate at all; miscommunication due to language barriers,
use of slang or acronyms, etc.; failure to ask questions when understanding is in doubt; or
failure to offer suggestions when change is needed;
3) Between shifts — inadequate turnovers due to poor (or rushed) verbal briefings, or inadequate
maintenance of records (job boards, check-off lists, etc.);
4) Between maintenance crew and lead — when the lead fails to pass important information to the
crew (including inadequate briefing at start of shift, or feedback on performance); when the crew
fails to report problems or opportunities to the lead; or when roles and responsibilities are
unclear;
5) Between lead and management — when management fails to pass important information to the
lead (including discussion of goals and plans, feedback on work completed, etc.); when the lead
fails to report problems or opportunities to management; etc.; and
6) Between the flight crew and maintenance crew — vague or incomplete logbook write-up; late
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Safety Management Manual (SMM) 安全管理手册(153)
