基于改进Bow-Tie模型的民航重着陆事件分析

An Analysis of Hard Landing Events in Civil Aviation Based on an Improved Bow-Tie Model

为深入分析我国民航重着陆事件信息,为重着陆事故预防提供实际参考,提出改进的Bow-Tie模型。在原因辨识环节将原因归纳为人、机、环、管四个方面,并通过数量统计对所有原因和后果进行量化。利用该模型分析了262起重着陆事件的原因、后果,并制定相应的预防控制措施和减少控制措施,建立重着陆事件改进Bow-Tie图。以2016年河北航空发生的重着陆及尾撬擦地事件为例进行实证分析。结果表明,重着陆事件改进Bow-Tie图内容涵盖了一般重着陆事件可能涉及的原因及后果信息,并包含针对性较强的预防和管控措施,能够为重着陆事件的预防和风险控制提供参考。

In order to thoroughly analyze hard landing events of civil flights in China ,and provide practical prevention measures, an improved Bow-Tie model is proposed. This model classifies all causes of hard landing events into the following four aspects： human,machine,environment,and management and statistically quantifies them. The causes and consequences of 262 hard landing events arc analyzed, with which preventive and reducing measures arc developed. An improved Bow-Tie diagram of hard landing events is established. A hard landing and tail-skid collision of Hebei Airlines in 2016 is selected as a ease study. The results show that the improved Bow-Tie diagram covers all possible causes and con-sequences of hard landing events, and can provide targeted measures for prevention and control. Therefore, it can serve as a reference for prevention and risk management of hard landing events.