Helicopter crashes into water: warning time, final position, and other factors affecting survival.

INTRODUCTION: According to 40 yr of data, the fatality rate for a helicopter crash into water is approximately 25%. Does warning time and the final position of the helicopter in the water influence the survival rate? METHODS: The National Transportation Safety Board (NTSB) database was queried to identify helicopter crashes into water between 1981 and 2011 in the Gulf of Mexico and Hawaii. Fatality rate, amount of warning time prior to the crash, and final position of the helicopter were identified. RESULTS: There were 133 helicopters that crashed into water with 456 crew and passengers. Of these, 119 occupants (26%) did not survive; of those who did survive, 38% were injured. Twelve died after making a successful escape from the helicopter. Crashes with < 15 s warning had a fatality rate of 22%, compared to 12% for 16-60 s warning and 5% for > 1 min. However, more than half of fatalities (57%) came from crashes for which the warning time could not be determined. DISCUSSION: Lack of warning time and how to survive in the water after the crash should be a topic for study in all marine survival/aircraft ditching courses. Investigators should be trained to provide estimates of warning time when investigating helicopter crashes into water.

Helicopter crashes related to oil and gas operations in the Gulf of Mexico.

INTRODUCTION: The hazards inherent in flight operations in the Gulf of Mexico prompted investigation of the number and circumstances of crashes related to oil and gas operations in the region. METHODS: The National Transportation Safety Board (NTSB) database was queried for helicopter crashes during 1983 through 2009 related to Gulf of Mexico oil or gas production. The crashes were identified based on word searches confirmed by a narrative statement indicating that the flight was related to oil or gas operations. RESULTS: During 1983-2009, the NTSB recorded a total of 178 helicopter crashes related to oil and gas operations in the Gulf of Mexico, with an average of 6.6 crashes per year (5.6 annually during 1983-1999 vs. 8.2 during 2000-2009). The crashes resulted in a total of 139 fatalities, including 41 pilots. Mechanical failure was the most common precipitating factor, accounting for 68 crashes (38%). Bad weather led to 29 crashes (16%), in which 40% of the 139 deaths occurred. Pilot error was cited by the NTSB in 83 crashes (47%). After crashes or emergency landings on water, 15 helicopters sank when flotation devices were not activated automatically or by pilots. DISCUSSION: Mechanical failure, non-activation of flotation, and pilot error are major problems to be addressed if crashes and deaths in this lethal environment are to be reduced.

Aviation-related injury morbidity and mortality: data from U.S. health information systems.

INTRODUCTION: Information about injuries sustained by survivors of airplane crashes is scant, although some information is available on fatal aviation-related injuries. Objectives of this study were to explore the patterns of aviation-related injuries admitted to U.S. hospitals and relate them to aviation deaths in the same period. METHODS: The Healthcare Cost and Utilization Project (HCUP) Nationwide Inpatient Sample (NIS) contains information for approximately 20% of all hospital admissions in the United States each year. We identified patients in the HCUP NIS who were hospitalized during 2000-2005 for aviation-related injuries based on the International Classification of Diseases, 9th Revision, codes E840-E844. Injury patterns were also examined in relation to information from multiple-cause-of-death public-use data files 2000-2005. RESULTS: Nationally, an estimated 6080 patients in 6 yr, or 1013 admissions annually (95% confidence interval 894-1133), were hospitalized for aviation-related injuries, based on 1246 patients in the sample. The average hospital stay was 6.3 d and 2% died in hospital. Occupants of non-commercial aircraft accounted for 32% of patients, parachutists for 29%; occupants of commercial aircraft and of unpowered aircraft each constituted 11%. Lower-limb fracture was the most common injury in each category, constituting 27% of the total, followed by head injury (11%), open wound (10%), upper extremity fracture, and internal injury (9%). Among fatalities, head injury (38%) was most prominent. An average of 753 deaths occurred annually; for each death there were 1.3 hospitalizations. CONCLUSIONS: Aviation-related injuries result in approximately 1000 hospitalizations each year in the United States, with an in-hospital mortality rate of 2%. The most common injury sustained by aviation crash survivors is lower-limb fracture.

Crashes of sightseeing helicopter tours in Hawaii.

INTRODUCTION: Crashes of sightseeing helicopter flights in Hawaii and the resulting tourist deaths prompted the FAA to issue regulations in 1994 specific to air tours in Hawaii. Research was undertaken to examine the effect of the 1994 Rule and to describe the circumstances of such crashes. METHOD: From National Transportation Safety Board data, 59 crashes of helicopter air tour flights in Hawaii during 1981-2008 were identified; crash investigation reports were read and coded. Crashes in 1995-2008 were compared with those in 1981-1994. RESULTS: The 1994 Rule was followed by a 47% decrease in the crash rate, from 3.4 to 1.8/100,000 flight hours. The number of crashes into the ocean decreased from eight before the Rule to one afterwards. VFR-IMC crashes increased from 5 to 32% of crashes. There were 46 tourists and 9 pilots who died in 16 fatal crashes. Aircraft malfunctions, primarily due to poor maintenance, precipitated 34 (58%) of the crashes and persisted throughout the 28-yr period. Pilot errors were apparent in 23 crashes (39%). Flight from visual to instrument conditions occurred in two cases before the Rule and seven cases after. Terrain unsuitable for landing was cited in 37 crashes (63%). CONCLUSION: Decreases occurred in the overall number and rate of crashes and in ocean crash landings. The increase in VFR-IMC crashes may be related to the requirement that tour helicopters fly at least 1500 ft. above terrain. Attention is still needed to maintenance, pilot training, and restricting flights to operating areas and conditions that enable safe emergency landings.

EMS helicopter crashes: what influences fatal outcome?

STUDY OBJECTIVE: In recent years, air transport of patients has been associated with disproportionate increases in crashes and deaths. We identify factors related to fatal outcome in air medical helicopter crashes and suggest preventive measures. METHODS: This was a retrospective study using National Transportation Safety Board records for helicopter emergency medical services (EMS) crashes between January 1, 1983, and April 30, 2005. The main outcome measure was the percentage of air medical crashes resulting in 1 or more deaths. RESULTS: There were 182 helicopter EMS crashes during the 22.3-year study period; 39% were fatal. One hundred eighty-four occupants died: 45% of the 44 patients and 32% of the 513 crewmembers. Fifty-six percent of crashes in darkness were fatal compared with 24% of crashes not in darkness. Seventy-seven percent of crashes in instrument meteorological conditions were fatal compared with 31% in visual conditions. Thirty-nine percent of all deaths occurred in crashes with postcrash fires; 76% of crashes with postcrash fire were fatal compared with 29% of other crashes. Multivariate logistic regression revealed that controlling for other factors, the odds of fatal outcome was increased by postcrash fire (odds ratio [OR] 16.1; 95% confidence interval [CI] 5.0 to 51.5], bad weather (OR 8.0; 95% CI 2.4 to 26.0), and darkness (OR 3.2; 95% CI 1.3 to 7.9). CONCLUSION: Fatalities after helicopter EMS crashes are associated especially with postcrash fire and with crashes that occur in darkness or bad weather and can be addressed with improved crashworthiness and measures to reduce flights in hazardous conditions. Further studies will be necessary to determine which changes will decrease the fatal crash rate and which are cost effective.

Crash-resistant fuel system effectiveness in civil helicopter crashes.

BACKGROUND: Crash-resistant fuel systems (CRFS) have demonstrated close to 100% effectiveness in survivable crashes of Army helicopters, but the technology has been slow to transfer into the civil helicopter arena. Federal standards for civil helicopter CRFS are less stringent than those for military helicopters. A reduction in standards for CRFS in military helicopters is being considered. OBJECTIVE: The goal of this study was to determine whether crashes of civil helicopters with CRFS are less likely to result in post-crash fire than crashes of those without. METHOD: Crashes of civil helicopters during 1982-2004 were analyzed, comparing Bell 206 helicopters manufactured with CRFS with Aerospatial 350 helicopters manufactured during the same period (post-1981), but lacking CRFS. Bell 206 helicopters with CRFS were also compared with earlier models without CRFS. RESULTS: The highest proportion of crashes with post-crash fires (11.3%) was in AS-350s manufactured after 1981 (non-CRFS), and the lowest (3.7%) was in Bell 206s (with CRFS) [unadjusted risk ratio (RR) = 3.3, 95% confidence interval (CI) = 1.04, 10.50; adjusted for light and weather, RR = 2.81, Cl = 0.82, 9.69]. Earlier models of Bell 206s without CRFS had higher risk of post-crash fire than post-1981 models with CRFS (7.4% vs. 3.7%; adjusted RR = 2.11, Cl = 0.82, 5.45). CONCLUSIONS: The results of this study suggest a better performance, in terms of post-crash fire prevention, of CRFS-equipped civil helicopters as compared with those without CRFS. It is possible that CRFS in civil helicopters have not achieved the same degree of effectiveness as CRFS in military helicopters. CRFS should be used more widely in civil helicopters. The more stringent CRFS requirements for military helicopters should not be reduced without further research.