Form 0920-21AN Pilot Survey

Examining Safety and Health among Aviation Industry Workers in Alaska: A Survey

Attachment 3b

Pilot Survey

OMB: 0920-1343

Document [docx]
Download: docx | pdf








Attachment 3b. Pilot Survey




















Shape1

Form Approved

OMB NO. 0920-xxxx

Expiration Date: xx/xx/20xx



NIOSH2018 - Aviation Safety – Pilots


Screening Question: Q00 Do you currently work for (Pipe in company name)?

  • Yes, I work for (Pipe in company name).

  • Yes, I work for (Pipe in company name) seasonally, occasionally, on-call, or when needed

  • No, I no longer work for (Pipe in company name).

Skip To: END of Survey if Do you currently work for (Pipe in company name)? = No, I no longer work for (Pipe in comp…)


Screening Question: Q00 Do you currently work as a pilot?

  • Yes, I work as a pilot.

  • No, I no longer work as a pilot.

Skip To: END of Survey if Do you currently work as a pilot? = No, I no longer work as a pilot.


Q0 INSERT CONSENT FORM HERE

  • I agree to participate in this study.

  • I do not agree to participate in this study.

Shape2

Public reporting burden of this collection of information is estimated to average 25 mins per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).


Skip To: END of Survey IF Informed Consent = I do not agree to participate in this study.


These first questions ask about your entire career as a pilot.


Q1 Over your entire career, how many years have you been a pilot? Please enter the number of months if less than 1 year.


  • Years: ___________________

  • Months: ___________________


Q2 Over your entire career, how many different companies have you worked for as a pilot?

  • Number of companies: ________________________________________________


If Over your entire career, how many different employers have you work for… # Employers > 1


Q2a Over how many years has that been?

  • Years: ________________________________________________



These questions are about your current job as a pilot.


Q3 Which of the following best describes your position as a pilot?

  • Captain

  • First officer

  • Other. Please specify: ________________________________________________



Q4 How long have you worked for your company?

Please enter the number of months if less than 1 year.

  • Years: ________________________________________________

  • Months: ________________________________________________



Q5 How long have you worked for your company as a pilot?

Please enter the number of months if less than 1 year.

  • Years: ________________________________________________

  • Months: ________________________________________________



Q6 In general, do you work as…

Please check all that apply.

  • A single pilot

  • A member of a multi-pilot crew

  • Something else. Please specify: ________________________________________________


Q7 Do you routinely perform tasks that are not in your job description?

  • Yes

  • No

  • I don’t know



Display This Question:

If Do you routinely perform tasks that are not in your job description? = Yes


Q7a What three tasks do you perform most often that are not in your job description?

  • Task 1: ________________________________________________

  • Task 2: ________________________________________________

  • Task 3: ________________________________________________


Q8 What pilot ratings and certificates do you hold?
Please select all that apply.

  • Commercial

  • Instrument

  • Airline Transport

  • Helicopter

  • Flight Instructor

  • Single-engine land

  • Multi-engine land

  • Single-engine sea

  • Multi-engine sea

  • Other. Please specify: ________________________________________________


Q9 On your FAA pilot certificate, is your address in Alaska?

  • Yes

  • No


Q10 Please fill in the table below with the number of hours flown in Alaska and in all locations, including Alaska, for your total flight career and during the last 12 months.


*If you are using a mobile device, like a smart phone or tablet, please turn it sideways so you can see the full question. You may need to turn off your "screen lock" feature so the screen will turn. 



Alaska

All locations (including Alaska)


Total Flight Career

Last 12 Months

Total Flight Career

Last 12 Months

Total paid flight hours





Instrument hours





Current employer hours





Q11 Thinking about the number of years you have flown in Alaska, has your work ever been seasonal?


  • Yes

  • No


Display This Question:

If Thinking about the number of years you have flown in Alaska, has your work ever been seasonal?= Yes

Q11a How many years was your work seasonal?

  • Years


Q12 Thinking about the number of years you have flown in Alaska, has your work ever been year-round?

  • Yes

  • No


Display This Question:

If Thinking about the number of years you have flown in Alaska, has your work ever been year-round? = Yes


Q12a How many years was your work year-round?

  • Years



These next questions are about your work schedule as a pilot.


Q13 Some people work a rotating schedule such as 2 weeks on and 2 weeks off. Do you currently work a rotating schedule?

  • Yes

  • No


Display This Question:

If Some people work a rotating schedule such as 2 weeks on and 2 weeks off. Do you currently work a rotating schedule? = Yes


Q13a Do you currently work...

  • 1 week on and 1 week off

  • 2 weeks on and 2 weeks off

  • 3 weeks on and 1 weeks off

  • Other. Please specify: ________________________________________________


Q14 Is your work for your current employer seasonal or year-round?

  • Year-round

  • Mostly year-round

  • Seasonal

  • Mostly seasonal

  • Other. Please explain______


Q15 Please estimate what percent of your paid flight hours in YEAR occurred in each season. 

Spring: _______

Summer: _______

Autumn: _______

Winter: _______

Total: ________


Q16 Does your work as a pilot have a peak season?

  • Yes

  • No

  • I don’t know


Display This Question:

If Does your work as a pilot have a peak season? = Yes

Q16a Have you worked during peak season as a pilot?

  • Yes

  • No


Display This Question:

If Does your work as a pilot have a peak season? = Yes AND Have you worked during peak season as a pilot? = Yes

Q17 During the peak season, what is your typical duty time each day?

Please enter your typical duty time in 24-hour clock format. That is, for 7:00 AM please enter 0700; for 1:00 PM please enter 1300.


  • From: ________________________________________________

  • To: ________________________________________________



Display This Question:

If Does your work as a pilot have a peak season? = Yes AND Have you worked during peak season as a pilot? = Yes


Q18 On the days you work during the peak season, how many flight hours per day do you typically log?

  • Flight hours per day: ________________________________________________

Display This Question:

If Does your work as a pilot have a peak season? = Yes AND Have you worked during peak season as a pilot? = Yes


Q19 During the peak season, how many days per week do you typically work?

  • Duty days per week: ________________________________________________


Display This Question:

If Does your work as a pilot have a peak season? = Yes AND Have you worked during peak season as a pilot? = Yes


Q20 During the peak season, do you typically work more than 40 hours per week?

  • Yes

  • No


Display This Question:

If During the peak season, do you typically work more than 40 hours per week? = Yes

Q20a During the peak season, about how many hours over 40 do you work per week?

  • Hours over 40 per week: _________________



Display This Question:

If Does your work as a pilot have a peak season? = No -OR- I don’t know OR Have you worked during peak season as a pilot? = No


Q17z What is your typical duty time each day?
  
Please enter your typical duty time in 24-hour clock format. That is, for 7:00 AM please enter 0700; for 1:00 PM please enter 1300.

  • From: ________________________________________________

  • To: ________________________________________________


Display This Question:

If Does your work as a pilot have a peak season? = No -OR- I don’t know OR Have you worked during peak season as a pilot? = No


Q18z How many flight hours per day do you typically log?

  • Flight hours per day: ________________________________________________


Display This Question:

If Does your work as a pilot have a peak season? = No -OR- I don’t know OR Have you worked during peak season as a pilot? = No


Q19z How many days per week do you typically work?

  • Duty days per week: ________________________________________________


Display This Question:

If Does your work as a pilot have a peak season? = No -OR- I don’t know OR Have you worked during peak season as a pilot? = No


Q20z Do you generally work more than 40 hours per week?

  • Yes

  • No


Display This Question:

If Do you generally work more than 40 hours per week? = No


Q20az About how many hours over 40 do you work per week?

  • Hours over 40 per week: _________________


These next questions are about weather and decision-making in your job.


Q21 From the list of resources below, which ones do you use when making decisions to launch flights?
Please select all that apply.

  • Flight Service Station - in person

  • Flight Service - by telephone (1-800-WXBRIEF)

  • Alaska Aviation Weather Unit online – (weather.gov/aawu)

  • Aviation Weather Center online (aviationweather.gov)

  • Aviation applications (Aerovie, Foreflight, SkyVector, Garmin Pilot)

  • AWOS/ASOS/ATIS

  • FIS-B Weather

  • Weather cameras

  • PIREPs

  • Other pilots who are en route or have flown in that area that day

  • Station manager, company personnel, or village agent at destination

  • Dispatchers, flight followers, or other company personnel

  • Unofficial weather observer

  • Other. Please specify: ________________________________________________


Q22 While working for your current employer, have you ever declined a flight due to poor visibility or other weather-related reasons?

  • Yes

  • No

  • Prefer not to answer

Display This Question:

If While working for your current employer, have you ever declined a flight due to poor visibility or other weather-related reasons?= Yes


Q22a Did the company support your decision?

  • Yes

  • No

  • Other. Please explain

  • Prefer not to answer



Q23 How often do you fly into weather that is different from what was predicted when you started your flight? 

  • Daily

  • Weekly

  • Monthly

  • Less often than monthly

  • Never



Q24 How often do you have to decide whether to fly on a Visual Flight Rules (VFR) flight plan into unknown weather conditions that may deteriorate below VFR minimums? 

  • Daily

  • Weekly

  • Monthly

  • Less often than monthly

  • Never


Q25 If you refuse to launch a flight due to marginal weather, how likely is it that your customers will fly with a different company? 

  • Not at all likely

  • Somewhat likely

  • Very likely

  • I don’t know



Q26 Do you have standard procedures to follow if you unexpectedly fly into Instrument Meteorological Conditions (IMC)? 

  • Yes

  • No

  • I don't know


Q27 How confident are you that you can safely fly under Visual Flight Rules (VFR) in the following conditions?


Whiteout conditions are when blowing snow, fog, or haze limit all visual references.

Flat light conditions are when an overcast limits visual cues, the features of the terrain, and make it hard to determine distance.





Not confident

Somewhat confident

Very confident

Whiteout conditions

Low visibility conditions

Flat light conditions



These next few questions ask about training and safety.


Q28 Please indicate if your current employer has provided you with training or check rides to help you deal with...


*If you are using a mobile device, like a smart phone or tablet, please turn it sideways so you can see the full question. You may need to turn off your "screen lock" feature so the screen will turn. 


Whiteout conditions are when blowing snow, fog, or haze limit all visual references.

Flat light conditions are when an overcast limits visual cues, the features of the terrain, and make it hard to determine distance.





Ground training

Flight simulator

Check rides

Yes

No

Yes

No

Yes

No

Recovery from inadvertent flight into IMC

Whiteout conditions

Low visibility conditions

Flat light conditions



Q29 In your current job as a pilot, did your employer provide you with training, equipment, or information on any of the following safety topics?



*If you are using a mobile device, like a smart phone or tablet, please turn it sideways so you can see the full question. You may need to turn off your "screen lock" feature so the screen will turn. 



Training

Equipment

Information


Yes

No

Yes

No

Yes

No

Hazardous materials safety

Fire safety

Ramp safety

Office safety

Lifting safely

Forklift use

Fall from heights prevention


Yes

No

Yes

No

Yes

No

Fall from the same level prevention

Prevention of slips on ice

Personal protective equipment use

Exposure to pathogens or chemical contaminants

De-escalation of threats from customers, passengers, or co-workers

Other. Please specify:





Q30 In your opinion, what additional training might reduce injuries, prevent illnesses, and increase safety? 

________________________________________________________________

________________________________________________________________

________________________________________________________________


Q31 While at work, about how often do you lift more than 50 pounds without equipment?

  • Daily

  • 2-3 times a week

  • Once a week

  • Once a month

  • 2-3 times a year

  • Never

  • Other. Please describe:


Q32 Is any of the following equipment available at work to assist with moving heavy items?
Please select all that apply.

  • Forklift

  • Pallet jack

  • Mechanical lift

  • Other. Please describe: ________________________________________________

  • None of the above



Q33 Compared to non-piloting jobs, how safe is your pilot job?

  • Much safer than other jobs

  • Slightly safer than other jobs

  • As safe as other jobs

  • Slightly more dangerous than other jobs

  • Much more dangerous than other jobs





The following questions are about work-related exposures, illnesses, and injuries and measures to eliminate them at your job as a pilot.

Examples of exposures are workplace exposures to harmful substances, fumes, loud noises, and temperature extremes.

Examples of illnesses are skin diseases, respiratory disorders, and poisonings resulting from work exposures.

Examples of injuries are work-related cuts, fractures, sprains, hearing loss, and amputations.

These questions refer to a time when your body was damaged and required medical attention at the time of the event, or caused you to take time away from work, or required you to change how you did your job.


Q34 Exposures in the workplace may be to harmful substances, fumes, loud noises, or temperature extremes. In the past five years, have you had any exposures as a result of your work that required medical care, first aid, time off work, or changes in how you do your job?


  • Yes. Please explain:

  • No


Q35 Other than piloting the aircraft, which of your duties or tasks are most likely to make you ill?

________________________________________________________________

________________________________________________________________

________________________________________________________________



Q36 In the past five years, have you been made ill as a result of your work?

  • Yes. Please explain:

  • No



Q37 Other than piloting the aircraft, which of your duties or tasks are most likely to injure you?

________________________________________________________________

________________________________________________________________

________________________________________________________________


Q38 In the past five years, have you been injured as a result of your work?

  • Yes

  • No


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes

Q39 In the past five years, how many different times have you been injured at work?

  • Once

  • Twice

  • Three or more times


Display This Statement:

If In the past five years, how many different times have you been injured at work?!= Once

AND

If In the past five years, have you been injured as a result of your work? = Yes


Please think about your most serious injury when answering these next questions.


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes

Q40 How did your injury occur?

  • Lifting (picking up cargo, baggage, equipment, etc.)

  • Slip (on ice, wet or oily surfaces, etc.)

  • Trip (over objects, uncovered hoses or cables, etc.)

  • Fall

  • Pushing or pulling

  • Contact injury with object (aircraft wing, tug, etc.)

  • Assault or injury by another person

  • Other. Please specify: ________________________________________________


Display This Question:

If How did your injury occur? = Fall

AND

If In the past five years, have you been injured as a result of your work? = Yes

Q40a Was your fall while you were above ground level or at ground level?

  • Above ground level (on a ladder, aircraft wing, etc.)

  • At ground level


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes


Q41 How was your injury treated?

Please select all that apply.

  • Did not receive any treatment

  • Received first aid at work

  • Self-treatment at home after work

  • Went to medical or community clinic

  • Went to hospital or emergency room, but wasn't admitted to hospital

  • Hospitalized 1-3 days

  • Hospitalized 4-7 days

  • Hospitalized more than 7 days

  • Received outpatient long-term care including therapy (physical, occupational, massage, counseling, etc.)

  • Other. Please explain: ________________________________________________


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes

Q42 Due to your injury, did you miss any workdays?

  • Yes

  • No

  • I don’t remember

  • Prefer not to answer


Display This Question:

If Due to your injury, did you miss any workdays? = Yes

AND

If In the past five years, have you been injured as a result of your work? = Yes

Q42a Due to your injury, about how much time did you miss from work?

  • Days ________________________________________________

  • Weeks ________________________________________________

  • Months ________________________________________________

  • Years__________________________________________________

  • I don’t remember


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes

Q43 What part or parts of your body were affected?
Please select all that apply.

  • Head

  • Neck

  • Upper limbs (shoulders, arms, hands, wrists)

  • Lower limbs (legs, knees, feet)

  • Trunk (back, lungs, stomach, chest, hips, buttocks)

  • Other. Please explain: ________________________________________________



Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes

Q44 At the time of your injury, about how long had you been at work that day?

  • Less than 1 hour

  • 1 – 2 hours

  • 3 – 5 hours

  • 6 – 8 hours

  • More than 8 hours

  • I don’t remember


Q45 Did you file a worker's compensation claim for your injury?

  • Yes

  • No, I didn’t have coverage at the time

  • No, other reason

  • I don’t remember

  • Prefer not to answer

Display This Question:

If Did you file a worker's compensation claim for your injury? = No AND

If In the past five years, have you been injured as a result of your work? = Yes

Q45a Which of following best describes your reasons for not filing a worker's compensation claim?

Please select all that apply.

  • I didn't think the injury was bad enough, filing was unnecessary

  • I didn't know I could

  • I didn't know how

  • I didn’t want to hurt the company or my employer

  • I didn’t want my employer to be disappointed in me

  • I was worried it would make me look bad

  • I didn’t want to get a co-worker in trouble

  • I was worried about getting in trouble with my employer

  • Other. Please describe: ________________________________________________


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes


Q46 Did you report your injury to your employer?

  • Yes

  • No

  • I don’t remember

  • Prefer not to answer


Display This Question:

If In the past five years, have you been injured as a result of your work? = Yes


Q47 Do you think your injury could have been prevented?

  • Yes. What could have prevented it? ________________________________

  • No. Please explain: ________________________________________________

  • I don't know




Q48 Please indicate how much you agree or disagree with each of the following statements. Where I work…



Where I work…

Strongly Disagree

Disagree

Neither Disagree nor Agree

Agree

Strongly Agree

the safety of workers is a high priority with management.

workers are discouraged from reporting safety issues.

there are no significant compromises or shortcuts taken when worker safety is at stake.

keeping aircraft in the air is more important than worker safety.

employees and management work together to ensure the safest possible working conditions.

management isn’t interested in safety issues.



Q49 What do you think contributes most to injuries in aviation in Alaska?

________________________________________________________________________________________________________________________________________________________________________________


Q50 If you could make changes, how would you make your job safer?

________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________


Q51 Have you ever felt so tired at work that you forgot what you were doing, what you had done, or made a mistake?

  • Yes

  • No

  • I don’t remember

  • Prefer not to answer




Q52 During YEAR, about how often would you have liked to decline a flight because you were too tired, but you flew anyway?

  • Daily

  • Weekly

  • Monthly

  • Less often than monthly

  • Never

  • Prefer not to answer


Display This Question:

If During YEAR, about how often would you have liked to decline a flight because you were too tired, but you flew anyway? != Never OR Prefer not to answer


Q52a When you continued to work despite being tired, you did so because…

Please select all that apply.

  • Your employer expected you to get the job done

  • Passengers were waiting

  • You needed the money

  • You didn’t want to let your coworkers down

  • You didn't want to let your company down

  • Other. Please describe: ________________________________________________





Q53 In the list of equipment below, indicate how helpful you think each is in preventing aircraft crashes:


Not helpful

Somewhat helpful

Very helpful

Don't know

Autopilot

ADS-B

(Automatic Dependent Surveillance-Broadcast)

VOR (Very high frequency omni-directional range navigation equipment)

GPS

(Global Positioning System)

NDB

(Non-directional beacon)

Interactive map

TAWS

(Terrain awareness and warning system)

TCAS

(Traffic collision avoidance system)

Other. Please describe:



Q54 In the list of equipment below, indicate how helpful you think each is in surviving after a crash:



Not helpful

Somewhat helpful

Very helpful

Don't know

Satellite phone

Cell phone

Personal Location Beacon

ELT (Emergency Locator Transmitter)

Satellite Tracking Device (Spidertracks, SPOT)

Survival kit

Other. Please describe:






The questions in the table below ask for your opinion about measures that might improve aviation safety throughout Alaska (not just at your company).


Q55 Please indicate how effective you think each measure would be in preventing aircraft crashes if widely applied in Alaska aviation.


Whiteout conditions are when blowing snow, fog, or haze limit all visual references.

Flat light conditions are when an overcast limits visual cues, the features of the terrain, and make it hard to determine distance.





Not effective

Somewhat effective

Very effective

Don't know

Pilot training in meteorology

Pilot training in aeronautical decision-making

Pilot training in whiteout conditions

Pilot training in flat light conditions


Not effective

Somewhat effective

Very effective

Don't know

Pilot training in CFIT avoidance

Pilot training in regional hazards

Greater ability to refuse flights due to weather

Easing of time limit to move by-pass mail


Not effective

Somewhat effective

Very effective

Don't know

Changes in Medicare patient transport requirements

Improvement in infrastructure to allow more IFR flights

Improvements in company operational control structures


Q56 Thinking of the measures you just rated, if you had to choose only two as most useful, which would they be?

  • First choice: (Dropdown list of 11 measures in Q55 above)

  • Second choice: (Dropdown list of 11 measures in Q55 above)



Q57 If there are other measures that you believe might improve aviation safety in Alaska, but which weren’t listed in the two questions above, please list them below.

________________________________________________________________________________________________________________________________________________________________________________


Q58 What do you think contributes most to aviation accidents in Alaska?

________________________________________________________________________________________________________________________________________________________________________________


These final questions are about you.


Q59 What is the highest level of education you have completed?

  • Less than high school

  • Attended high school; didn't graduate

  • GED or equivalent

  • High school diploma

  • Attended college; no degree

  • Associate's degree

  • Bachelor's degree

  • Graduate or Professional degree


Q60 Are you male or female?

  • Male

  • Female

  • Prefer not to answer



Q61 How old are you?

  • Years: ________________________________________________

  • Prefer not to answer


Q62 What is your race?
Please select all that apply.

  • American Indian or Alaska Native

  • White

  • Black or African American

  • Native Hawaiian or Other Pacific Islander

  • Asian

  • Some other race. Please specify: ___________________________

  • Prefer not to answer



Q63 Please add any other comments about aviation safety in Alaska you think we should know.

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________

________________________________________________________________






Thank you for your help!




End of Survey



File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleNIOSH2018 - Aviation Safety_Pilots
AuthorOConnor, Mary B. (CDC/NIOSH/WSD)
File Modified0000-00-00
File Created2021-03-29

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