Fatalities In Airports: A Concerning Number Of Deaths

Air travel is considered one of the safest modes of transportation. However, aviation accidents do occur, and the results can be devastating. While it is rare, people do sometimes die on commercial flights. A study in the New England Journal of Medicine found that a medical emergency occurs in the skies about once every 600 flights, with the most common issues being fainting, respiratory problems, heart trouble, and nausea or vomiting. In 2021, there were 176 air traffic fatalities worldwide, a number that has been decreasing over time.

In-flight medical emergencies

While it is unclear how many people die in airports, a review of 18 individual studies with approximately 1.5 billion passengers found that the all-cause mortality rate of in-flight medical emergencies was 0.21 per million passengers. This equates to approximately 21 deaths per 10 billion passengers.

Up to 70% of in-flight medical emergencies are managed by the cabin crew without additional assistance. If a health care volunteer is requested, they should consider if they are in an appropriate condition to render aid, and then identify themselves to the cabin crew. Aircraft in flight are physically constrained and resource-limited environments. All US aircraft with at least one flight attendant and a capacity of 30 or more passengers are required to carry an emergency medical kit and automated external defibrillator.

Overall, while in-flight medical emergencies are rare, they can be life-threatening and require prompt and effective management by cabin crew, medical volunteers, and ground-based medical support.

Aviation accident statistics

Aviation accidents are rare but often have devastating consequences. Air travel is statistically the safest form of transport, and the overall trend in recent years has been a reduction in the number of fatalities, despite an increase in air traffic.

In 2021, there were 176 deaths worldwide due to air crashes. In the US, the National Transportation Safety Board (NTSB) tracks aviation accident statistics and, in 2007, estimated a total of nearly 24 million flight hours. Of these 24 million hours, 6.84 of every 100,000 flight hours involved an airplane crash, with 1.19 of every 100,000 being fatal. This is down from 9.08 accidents per 100,000 hours in 1994.

Human error is thought to account for up to 80% of aviation accidents, with pilot error being the main cause at 53%. Mechanical failure and weather conditions are also contributing factors, at 21% and 11% respectively. The most dangerous times for a flight are during takeoff and landing and the periods immediately before and after these events.

General aviation aircraft, which include all civilian flights except for passenger or cargo transport scheduled by an airline company, are involved in almost 78% of crashes. This is partly because there are many more of these flights than commercial ones. However, general aviation flights also have a higher rate of fatal accidents, at almost 45%.

In-flight medical emergencies occur about once every 600 flights, and very rarely end in death (0.3% of the time).

Fatalities per 100,000 flight hours

While air travel is considered one of the safest modes of transportation, accidents and fatalities do still occur. In 2007, the National Transportation Safety Board (NTSB) of the United States estimated a total of 24 million flight hours, of which 6.84 per 100,000 flight hours resulted in an airplane crash, with 1.19 per 100,000 yielding a fatal crash. This was a decrease from 1994, when 9.08 accidents occurred per 100,000 flight hours.

In 2018, the Federal Aviation Administration (FAA) set a goal to reduce the general aviation fatal accident rate by 10% over a 10-year period from 2009 to 2018. While the fatal accident rate was declining, 347 people died in 209 general aviation fatal accidents in 2017.

According to the National Transportation Safety Board, in 2022, major airlines (scheduled service) experienced no onboard fatalities and had a fatal accident rate of 0 per 100,000 flight hours. In contrast, general aviation had a higher fatal accident rate of 0.945 per 100,000 flight hours, resulting in 339 onboard fatalities.

It is worth noting that these statistics may not include all private flights due to lax government regulations and non-reporting. Private plane crashes have been on a downward trend since the 1980s, but user error and insufficient training continue to contribute to accidents.

Accidents during landing or takeoff

Accidents during takeoff and landing are the most common types of aviation accidents and can have deadly consequences. During these critical phases of flight, planes are closest to the ground, travelling at slower speeds, and forced to do more manoeuvring. These factors leave little room for error, and even a small mistake can be dangerous.

Takeoff and landing are also the most complex phases of flight, requiring pilots to closely monitor instruments, communicate with air traffic controllers, and observe environmental conditions. This complexity, combined with varying parameters such as airspeed, altitude, and temperature, pose a greater level of risk than cruising. Environmental factors, such as winds, also have a more significant impact on aircraft closer to the ground.

According to a Boeing study, 48% of all fatal accidents worldwide between 2007 and 2016 occurred during the final descent and landing. The second most perilous stage is during takeoff and initial climb, accounting for 13% of fatal incidents. Overall, nearly half of all aviation accidents occur during the final approach or landing, and 14% occur during takeoff or initial climb.

Common causes of accidents during these critical phases include pilot error, air traffic controller error, mechanical failure, maintenance issues, and bad weather. For instance, engine blowouts, fires, runway debris, and bird strikes can cause accidents during takeoff. Poor weather conditions can also make it more difficult for pilots to control speed and keep the plane level when close to the ground.

While flying remains one of the safest ways to travel, the high number of accidents during takeoff and landing underscores the importance of managing descent, ensuring proper maintenance, and closely monitoring environmental factors to enhance safety during these critical phases of flight.

Handling passenger deaths mid-flight

Although mid-flight deaths are extremely rare, they can be traumatic for everyone involved. In the event of a death mid-flight, there are procedures that airlines follow to handle the situation.

Resuscitation and Pronouncement of Death

According to guidelines published by the International Air Transport Association (IATA), cabin crew should attempt resuscitation using Automated External Defibrillators (AEDs) available on most planes. CPR should be performed until breathing and circulation resume, it becomes unsafe to continue, all rescuers are exhausted, the aircraft has landed, or the person is presumed dead. If CPR is performed for 30 minutes or longer without signs of life and no shocks are advised by the AED, the person may be presumed dead.

While a physician on board can legally pronounce a passenger dead, in most cases, the pilot must decide whether to divert the flight or continue to the destination. If there is no doctor on board, airlines can connect with medical services on the ground for assistance.

Notification and Diversion

Pilots typically notify ground staff of a medical emergency rather than a death and may choose not to divert the flight. In such cases, the cabin crew is responsible for handling the body until landing. The crew should move the deceased to a seat with few nearby passengers or an area that doesn't obstruct the aisle or exit. If necessary, the body may be covered with a blanket, and the person's eyes should be closed.

Post-Landing Procedures

The focus of post-landing procedures is on dignity and respectful handling of the deceased. The person may be moved to a more private area, such as a crew rest area or first class, if possible. While there are tales of corpses being left in their seats with oxygen masks in place, there is no data to suggest this is a widespread practice.

Repatriation and Costs

The repatriation process, including the transport of the body across international borders, can be complex and may require specialist agencies. The costs associated with these processes may or may not be covered by insurance.

Overall, while mid-flight deaths are uncommon, airlines follow guidelines and work with medical professionals to handle these situations with sensitivity and respect for the deceased and all involved.

Frequently asked questions