Aviation safety was back in the news earlier in 2008, following the crash landing of a Boeing 777 just inside the perimeter fence at London’s Heathrow airport on 18 January. Back in 2000, the Chief Medical Officer for England, Liam Donaldson, drew heavily on the airline industry in his seminal report on patient safety “An Organisation with a Memory.” Since then, aviation has become the case study of choice when translating lessons on safety from the commercial arena to healthcare. A few examples of the genre are included in the references to this article.1^–6 Airline practice has much to teach us about safety culture and systems, but it may not be the best overall comparator. Making safety a top priority is the biggest challenge in healthcare. In aviation, where safety failures lead to catastrophe and death on a grand scale, prioritising safety is a non-issue. Therefore, by focusing so narrowly on the airline sector, we may be missing useful lessons from other industries.

Mining is a very old, dirty and labour-intensive business, with clear parallels …