Design of a job aid for airline handlers: a system for the safe handling and stowage of mobility aids during air travel

Alignment with international standards

Researchers consulted with the chair of the Assistive Technology for Air Travel (ATAT) standards committee at the Rehabilitation Engineering Society of North America (RESNA). In 2021, ATAT published AT-1, a new standard that specifies the handling and storage of assistive technologies (AT) for air travel (RESNA, 2021). The AT-1 standard includes a recommended air travel configuration card and set of labels that mobility aid original equipment manufacturers (OEM) can provide their customers at point of purchase. Customers can apply these labels to their mobility aid to provide ground handlers guidance on how to move and secure their specific device for air travel, and the card can be attached to their mobility aid during transit to provide ground handlers additional and detailed instructions related to the labels (Figure 1).

Text description of figure 1

Air travel information

Manufacturer Model
COMPLIANT with RESNA AT-1

Owner: John Doe
Phone:
Email: john.doe​@email.com
Chair series number: 720003

Air travel preparation

The owner of this device, or a designated assistant, is encouraged to participate in the following process.

• Remove seat cushion: Remove seat cushion; store in aircraft cabin.
• Remove head support: Remove head support; store in aircraft cabin.
• Lower back support to fit into aircraft: Remove back support cushion; store in aircraft cabin. Cushion is fixed in place by means of Velcro on the rear. Disconnect quick release pin on back support actuator at the attachment point behind back support. Fold back support forward.
• Remove joystick: Remove electrical connection to joystick. Remove joystick controller; store in aircraft cabin.
• Raise foot supports: Move foot supports to upright position.
• Isolate battery power: Switch breaker to off to fully disconnect power.
• Disengage drive system: Rotate level on each motor to manually push the mobility device.

Air travel configuration

• Height: 601 mm (23.7 in)
• Length: 864 mm (34.0 in)
• Width: 635 mm (25.0 in)

Driving configuration

• Height: 1207 mm (47.5 in)
• Length: 1064 mm (41.9 in)
• Width: 635 mm (25.0 in)

Unoccupied product weight
150 kg (330 lb)

Warning: This product should be lifted using a mechanical lift to avoid injury.

Battery information

Warning: Only non-spillable lead acid group 34 batteries may be installed on this product.

This wheelchair was manufactured with 2 lead acid sealed gel cell non-spillable batteries conforming to DOT 49 CFR 173.159(d) and IATA Provision A67.

Weight of additional components
(if greater than 10 kg)
kg
lb

Rev: 2023-09-05

Similarly, IATA provides guidelines for the design of ground handler job aids in their manual on the transportation of mobility aids (IATA, 2023). The guidance was developed by the Mobility Aids Action Group which is composed of airlines, airports, industry associations, disability rights group members, handling agents, mobility aids manufacturers as well as government representatives and research associations (CTA, Transport Canada, and NRC are named contributors). The guidelines emphasize the importance of assisting ground handlers with clear, step-by-step instructions for securing and containing mobility aids in a cargo hold. Instructions should be concise, written in plain language, and primarily rely on visuals to ensure quick and effective reference for ground handlers operating in time-sensitive environments.

Research and design methodology

The mixed-methods project was developed over two phases and completed in 32 weeks. In the first phase researchers conducted semi-structured interviews with 21 SMEs, including 2 mobility aid air travel experts (who designed the RESNA air travel configuration card), 2 wheelchair Original Equipment Manufacturer (OEM) professionals, 13 airport and airline managers, supervisors and directors, and 4 mobility aid advocates who are themselves mobility aid users. Each SME was invited to a 60-minute online interview to share insights on the procedures and challenges associated with transporting mobility aids by air. Additionally, researchers conducted an on-site workflow observation of 5 ground handlers from one airline at an international airport. While participating in the observation, ground handlers were asked a series of questions that provided context for their management of mobility aids. Thematic coding was used to analyse data collected from the interviews, and observations and findings informed the initial design of the job aid system prototype (Table 1).

In the second phase, researchers observed how the prototyped job aid system functioned across the check-in and ground handling operations of two airlines at the same international airport. A second cohort of 8 ground handlers (3 of who participated in the workflow observation) plus 6 check-in agents were recruited as participants and asked to evaluate the effectiveness of the prototype in a staged scenario. Additionally, 5 SMEs (2 mobility aid transportation experts and 3 mobility aid advocates from the original group) were also consulted in follow-up interviews to review the prototype, ensuring that multiple stakeholder viewpoints were captured. These evaluations and interviews were analysed using thematic coding, and findings contributed to a revised job aid system that is ready for integration into airline mobility aid operations as well as employee training programs and resources.

Vital information for handling

Findings underscore the importance of information when handling mobility aids. As one SME said, “When it comes to mobility aids, any spot I would assume would be the best part to hold turns out to be wrong about 50% of the time.” Another said, “Weight distribution becomes a huge challenge, so that's why we expect to have information beforehand.” Furthermore, mobility aids have different specifications and customizations. The complexity of the powered mobility aid is directly proportional to the disability of the user and a lack of clear instructions on how to handle the device often leads to damage during transport.

SMEs identified the following information as vital for successful handling:

1. Device weight and dimensions
2. Battery type and isolation
3. Strapping points for transportation
4. Removable parts and foldable parts
5. Break disengagement
6. Lifting points
7. Fragile parts
8. Smallest configuration

Standardization of procedures

Ground handlers face challenges when securing mobility aids for transit. As one SME pointed out, “Mobility aids were never designed to be strapped into an aircraft, and an aircraft was never designed to have a mobility aid in the cargo hold.” There is a fundamental design misalignment here worth noting, one that highlights the difficulty of transporting mobility aids.

Ground handlers can develop operational confidence with standard procedures. As one supervisor stated, “Standardization is really the best, the biggest win.” Another SME stated, “Standardizing helps ground handlers see the same information in the same way each time.” Findings also suggest OEMs are considering standardization in the development of mobility aids. One OEM professional said, “We’re going to look at the RESNA standard and abide by that as guidance on how to design for baggage handling.”

Timely and useful information

Ground handlers have a demanding work environment that limits their access to information while performing tasks. As one ground handler supervisor noted, “They only have 35 to 45 minutes to do their job,” emphasizing the time-sensitive nature of their tasks. To compound this, ground handling is physically demanding and often conducted outdoors in poor weather, and constraints such as regional regulations and economics as well as company policies may limit the use of technologies that could channel information.

Experience was also identified as a challenge. One training manager said, “Many ground handlers have zero experience beforehand. Many are part-time hires who meet minimum requirements.” This lack of prior experience shows the importance of simplifying information. Symbols, labels, and the communication of operating procedures need to be consistent and easy to understand. One airline director emphasized a visual approach, stating, “Pictures. 100% pictures. Like, no words. Honestly, anything to do with language isn't going to work.”

Knowledge and training

Handling mobility aids can be a challenge due to the wide variety of models, brands, and customizations. Devices can become highly complex and difficult to handle, as one SME stated, “When something major happens, it's because employees feel they know what they are doing, but they actually don't.” An SME said, “Most of the training happens on the job,” and another explained, “When it comes to mobility aids, it's kind of a dartboard. Training for the ground handler is lagging.” A powered mobility aid advocate further emphasized the need for updated training by commenting, “Powered mobility aids constantly keep changing, so the training on this should happen every year.” The development of training was discussed specifically with one SME reporting, “We are in the process of rolling out annual training for mobility aids.” Another said that training for ground handlers occurred every three years but indicated a shift toward more frequent and standardized education on the handling of mobility aids.

With regards to the kinds of training needed, one SME said ground handlers require both emotional and technical knowledge. Empathy is important to understand the emotional significance of a mobility aid to its user. Findings suggest ground handlers are already trained to recognize that a mobility aid is not just a device but an extension of the body. As one SME explained, “I think ground handlers are already well-versed in the most important thing: that this is somebody's legs, their freedom and independence. They are aware of that.”

Technical training is equally as important. One SME linked the experience of handling an unknown mobility device to being “a new parent frustrated that they can't close the baby stroller.” Without proper technical understanding ground handlers will be at a disadvantage when they are tasked with moving and securing mobility aids.

Loading wide-body aircraft

Wide body aircraft use unit load devices (ULDs), commonly referred to as containers. A specialized mobility aid transfer cart is used to load and unload a mobility aid from the container. A single container is used to load one mobility aid and containers with mobility aids are typically loaded last to enable them to be offloaded first upon arrival (Figure 2). According to ground handlers, the information sheet added to the exterior of the container may or may not have additional information related to the mobility aid.

Although researchers did not have a mobility aid during observations, ground handlers discussed how they load a device. Once the mobility aid is loaded into a container, they secure the straps to anchor points along the edge of the floor of the container, pass the straps through or over the main body of the mobility aid, and secure the straps on the other side of the container floor. Due to the unique design of each mobility aid, ground handlers must use their best judgement to identify where best to apply the straps.

Loading narrow-body aircraft

Smaller aircraft rely on belt loaders to stow the mobility aid directly inside the cargo hold. As per discussions with ground handlers, the use of belt loaders is more labor intensive and may increase the risk of damage due to the narrow size of the belt loader and small dimension of the cargo hold door (Figure 3). These restrictions are made more difficult due to the weight of mobility aids. Ground handlers move mobility aids from the aircraft boarding gate to the apron via an elevator near the jet bridge if available. If an elevator is unavailable, ground handlers push the device back to the terminal and through the airport using service elevators.

Once inside the cargo hold, ground handlers position the mobility aid for transport. Once positioned, they run straps through and over the main body of the mobility aid and secure them to anchor points on the floor, similar to how they secure a mobility aid in a container.

Requirements based on findings

Requirements were established to align the design of the job aid system with key findings and to ensure ground handlers have the information they need to handle the different kinds of mobility aids they may encounter (Table 2).

Integration of the job aid into air travel systems

These requirements framed the design of a three-part job aid system that can provide ground handlers, check-in agents and other airport personnel a standard procedure for handling mobility aids (Figure 4).

Job aid poster

The job aid poster provides ground handlers more detailed information on the sticker and card system. The poster can be strategically placed in lunchrooms, common areas, and baggage handling zones to familiarize ground handlers and airport personnel with the stickers they may encounter on a mobility aid to learn best practices for handling.

Text description of figure 4

Job aid for airline handlers: A system for the safe handling and stowage of mobility aids during air travel

1. Passenger receives information regarding the job aid system.
2. Passenger applies stickers to mobility aid with check-in agent.
3. Ground handler references card to move mobility aid after handover.
4. Ground handler secures mobility aid in cargo hold for departure.
5. Aircraft departs with mobility aid safely stored in cargo hold.
6. Mobility aid returned to passenger upon arrival at destination.

• Job aid stickers
• Job aid card
• Job aid poster

Feedback from check-in agents

The initial reaction from check-in agents after using the job aid stickers was positive, stating, “The idea is 100% good.” This sentiment was reinforced by another who remarked, “I think it's great. It's straightforward.” By following the instructions on the sticker sheet, check-in agents were able to identify and label critical areas of the mobility aid (Figure 5).

When asked to critique the stickers, check-in agents highlighted their effectiveness in identifying critical parts of a mobility aid. They appreciated the size, visibility, and clarity of the stickers, with comments such as, “The size of the stickers is fine,” and “Icons on the sticker sheet are good,” and “I love that it's yellow.” Others noted that, “All the stickers are understood” and emphasized their bright and visible colours.

Additionally, multiple check-in agents said they have a procedure for onboarding passengers with mobility aids and ask many of the same questions that are found on the sticker sheet. One agent confirmed this alignment, stating, “Yes, I think we'll use the sticker system because we actually ask these questions anyway at the check-in desk.”

One check-in agent did express concern, stating, “No, I wouldn't be comfortable putting stickers on a powered mobility aid if the user wasn't telling me exactly where to put those stickers. Because if I apply that sticker and something happens to their chair, then that would be on me.” The expressed concern suggests the need for training to reinforce the check-in agent’s role as a facilitator rather than the primary decision-maker in labelling mobility aids.

Another observation was that not all necessary information could be effectively communicated through the job aid symbols alone. In such cases, check-in agents instinctively began writing additional notes directly on the sticker sheet to capture specific details about the mobility aid. The prototype did not include a designated section for custom notes which became a noticeable limitation. Since every mobility aid is unique, the ability to add personalized handling instructions may be valuable.

Feedback from ground handlers

Ground handlers reported that the job aid system provided a structured approach to identifying critical information about mobility aids. Initial observations revealed ground handlers faced significant challenges in understanding how to properly handle mobility aids. When examining the powered mobility aids, ground handlers struggled with brake disengagement, highlighting gaps in their training and the need for additional support. Once the job aid system was introduced, ground handlers were able to quickly identify essential components and gain a better understanding of device functionality (Figure 6).

The effectiveness of the stickers and the card was observed in the jet bridge during hand-off between the passenger and the ground handler. Here, the ground handler started looking at the stickers on the powered mobility aid and quickly understood what to do. One ground handler said, “I found the job aid useful when we received the chair on the bridge because it speeds things up. We can identify the parts right away.”

Researchers observed some ground handlers relied on prior experience when making handling decisions, rather than referring to the card and stickers. However, in cases where they were uncertain, such as determining the correct lifting points or finding specific strapping points the stickers and card were referenced. After consulting the job aid system, ground handlers were able to understand the meaning of the symbols and apply the correct handling procedures.

The usability of the job aid card in a baggage handling environment was also noted. Given the physically demanding nature of the job, often performed in challenging weather conditions and exposed to various external factors, researchers aimed to determine whether the cards would be practical for long-term use. Observations suggest that carrying the job aid reference card would not pose a significant challenge for ground handlers as many already use lanyards and arm bands to hold identification and instructional cards.

Feedback from subject matter experts

Discussions with mobility aid advocates were primarily focused on the sticker sheet. Feedback was positive with one SME expressing that they liked the concept and another who said, “They’re actually very well detailed and well done.” However, one SME was unsure whether all the colours should be yellow and black. They suggested that red is typically used to signify the importance of danger and the fragile nature of their mobility aid.

A recurring concern was related to inconsistencies in check-in agent procedures, which one mobility aid advocate described by saying, “There's just a lot of inconsistency so I would just want to be assured that the individual I am talking to with these stickers, that we’re on the same page.”

One mobility aid advocate recommended check-in agents inform the user on the purpose and benefits of these stickers to avoid confusion at the check-in desk. They said, “I think the passenger needs to be well-versed in what to expect at check-in and what will happen once land.” A significant accessibility concern raised by another advocate was the need for a system that supports individuals with communication impairments, saying, “I was thinking of individuals I know who may be completely cognizant but have a very strong speech impediment. They might not be able to articulate.”

Mobility aid advocates expressed concerns about applying stickers to their own mobility aid. One said, “The first thing that came into my mind was that maybe people don't want to use the stickers.” When asked if they would be willing to put a sticker on their chair, an SME initially stated, “No, I would not.” However, after further reflection they said, “As long as it does not damage the chair.” Another advocate stated, “I love my chair. As long as the stickers are removable, great. But obviously, if they're going to be removable, they've got to go through getting on and off the aircraft.”

Mobility aid air travel experts were also consulted. Their review of the job aid system was favourable, stating the design was in alignment with the RESNA AT-1 standard and would provide an interim solution while OEMs adopt the air travel configuration card and labels. Moreover, the job aid system would be valuable if mobility aid users choose not to use the air travel configuration card and labels provided by OEMs.

Requirements based on findings

The evaluation of the design aid system with ground handlers and check-in agents and the interviews with SMEs were instrumental in defining requirements for the iteration of the job aid system (Table 6).

Final job aid sticker design

The updated job aid sticker design includes new Fragile, Custom Note and Return to Gate labels as well as a redesigned shape of the Removable Parts label (Figure 7).

Text description of figure 7

Mobility aid stickers

These stickers help ground handlers safely handle your mobility aid. If you need assistance applying these to your mobility aid or have any questions, please ask airline staff.

• Manual lifting points: Apply to the manual lifting points of your mobility aid.
• Strapping points: Apply to the tie-down points of your mobility aid.
• Power switch: Apply to the power (on and off) switch.
• Gear brakes: Apply to allow your mobility aid to be pushed.
• Foldable parts: Apply to any foldable parts, e.g., foot support.
• Battery type: Apply to specify if the battery is removable.
• Custom note: Apply if you have any special requests.
• Weight information: Apply to specify the weight of your mobility aid.
• Removable parts: Apply to the removable parts of your mobility aid, e.g., head support.
• Fragile: Apply to any fragile areas or parts on your mobility aid.
• Return to gate: Apply if your mobility aid needs to be returned to the gate.

If your mobility aid has been damaged please contact 613-123‑4567 or email accessible​@brandname.ca.

QR code: A scannable code is displayed. Scan QR to learn more about handling mobility aids.
Brand Name Airlines (logo with stylized wing)

Final job aid card design

The job aid card was updated to include reference to the revised labels. Instructions were added to remind ground handlers to consult with mobility aid users (Figure 8).

Text description of figure 8

Mobility aid sticker guide

Get passenger consent before handling their mobility aid and ask if the passenger want to take any removable parts into the cabin.

• Removable parts: Remove and store separately before loading.
• Foldable parts: Fold to reduce size and prevent damage.
• Power switch: Turn off mobility aid before handling.
• Removable battery: Detach and store safely before loading.
• Non-removable battery: Do not remove and transport mobility aid upright.

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• Gear brakes: Disengage before moving and re-engage when securing.
• Strapping points: Secure using marked strapping points on mobility aid.
• Fragile: Handle with care and avoid heavy pressure or loads.
• Manual lifting points: Lift only from these designated lifting points.
• Return to gate: Return mobility aid to passenger at arrival jet bridge.

QR code: A scannable code is displayed. Scan QR to learn more about handling mobility aids.
Brand Name Airlines (logo with stylized wing)

Final job aid poster design

Lastly, the job aid poster was updated with the revised labels and edited to include related information and instructions (Figure 9).

Text description of figure 9

Mobility aid sticker guide

Get passenger consent before handling their mobility aid. Follow this guide for best practices in handling and securing mobility aids for air travel.

• Strapping points: Secure using marked strapping points. Identify and use designated securement points. Attach straps only to the frame or structural tie-down points, not fragile parts like armrests, footrests, joysticks, or wheels. Do not over-tighten straps. Too much tension can damage mobility aid components, especially lightweight aluminum frames.
• Manual lifting points: Lift only from these designated points. Identify lifting points. Use the mobility aid stickers to find safe lifting points. If no points are marked, lift carefully to avoid damage. Use proper assistance. Large or heavy mobility aids require multiple trained personnel and should never be lifted alone.
• Power switch: Turn off mobility aid before handling. Switch off the mobility aid to prevent accidental activation while handling. Engage freewheel mode before moving to avoid motor damage when manually pushing or loading.
• Brakes: Disengage and re-engage before handling. Ensure brakes are disengaged in freewheel mode. Engaging the brakes while attempting to push or load the mobility aid can result in damage. Brakes should be applied before the mobility aid is strapped down in the cargo hold.
• Foldable parts: Fold to reduce size and prevent damage. Ask the passenger if parts should be folded. Fold protruding parts like reclining seatbacks, footrests, headrests, and armrests before handling and securing the mobility aid.
• Removable parts: Remove and store separately before loading. Ask the passenger if there are any removable joysticks, seat cushions, armrests, footrests, and headrests. Protect the joystick if it can’t be removed or the passenger can’t be consulted.
• Battery type: Check if the battery is removable. Remove lithium-ion batteries when required. If not securely attached, they must be removed and stored separately in the cabin. If securely attached and well protected, removal may not be necessary.
• Fragile: Handle with care and avoid heavy loads. Never place baggage on top of a mobility aid. Store in a designated cargo area without heavy items. Transport upright unless otherwise specified by the passenger or custom instructions.
• Return to gate: Return to passenger upon arrival. Unload the mobility aid from the cargo hold before baggage unloading and greet the passenger at the aircraft door. Inform the passenger or airline personnel at check-in if a return isn’t possible.

QR code: A scannable code is displayed. Scan QR to learn more about handling mobility aids.
Brand Name Airlines (logo with stylized wing)

Support for both official languages

The job aid system was designed to support both official languages in Canada and has the flexibility to support additional languages (Figure 10).

Text description of figure 10

Autocollants d’aide à la mobilité

Obtenez le consentement des passagers avant de manipuler leur aide à la mobilité et demandez-leur s’ils veulent apporter des pièces amovibles dans la cabine.

• Pièces amovibles: Retirez les pièces et entreposez-les séparément avant le chargement.
• Pièces pliables: Pliez les pièces pour réduire la taille et prévenir les dommages.
• Interrupteur d’alimentation: Éteignez l’aide à la mobilité avant de la manipuler.
• Batterie amovible: Détachez-la et rangez-la en toute sécurité avant le chargement.
• Batterie non amovible: Ne retirez pas et transportez l’aide à la mobilité à la verticale.

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• Freins: Débrayer les freins avant de déplacer l’aide puis réenclenchez-les.
• Points de fixation: Fixez l’aide à la mobilité à l’aide de points de fixation marqués.
• Fragile: Manipulez avec soin et évitez les fortes pressions ou les charges lourdes.
• Points de levage manuel: Ne soulevez l’aide à la mobilité qu’à partir de ces points désignés.
• Retour à la porte: Retournez au passager à la passerelle d’embarquement de l’arrivée.

Code QR : Un code scannable est affiché. Numérisez le code QR pour en savoir plus sur la manipulation des aides à la mobilité.
Brand Name Airlines (logo avec aile stylisée)

Job aid stickers

Stickers need to adhere to various surfaces such as cloth, metal, carbon fibre, plastic, and rubber while remaining removable without losing adhesive integrity. Vinyl stickers with ultraviolet ink and medium-strength adhesives are recommended. Stickers should be selected based on how well they perform in outdoor environments and respond to changes in temperature.

Job aid card

It is recommended cards are produced using a synthetic or plastic material that is both waterproof and thick enough to endure rough working conditions. A hole punch at the top or bottom will allow ground handlers to attach the card to a lanyard or insert it into an armband for quick access, ensuring that critical information is always within reach.

Job aid poster

The poster can be printed on durable cardstock with a protective varnish to enhance its durability when placed in high-traffic areas around the airport.

Cost of materials

Researchers contacted several print shops to estimate the cost of producing the job aid system. Table 7 represents a price range in CAD based on the average of three separate quotes.

Requirements based on findings

Researchers recommend future ground handling, check-in agent and airline personnel training reference these key requirements that have been amalgamated from all findings (Table 8).