Fears about flying have reached a fever pitch following the tragedy involving an Air India plane on June 12.
That fatal incident is just one of a string of recent aviation accidents to rattle the globe.
In the US alone, there have been 55 deadly crashes so far this year – including a high-profile disaster near Washington, DC, that killed six and reignited safety concerns.
But beyond the headlines, few understand what actually happens to the human body when an aircraft goes down.
Tony Cullen, a former aviation crash investigator who spent decades analyzing the mechanics of fatal air disasters, devoted his career to studying how passengers die in crashes in a bid to improve airline safety.
What he uncovered paints a sobering picture of what survivors and victims endure in their final moments.
The most common cause of injury, Cullen found before dying in 2009 at 70 years old, is not fire or drowning, but sheer blunt-force trauma.
‘Injuries are caused by the interaction of the victim with the aircraft,’ he wrote in one of his 2004 reports.
While the impact of a plane crash can cause death, fire is another major hazard
‘In many crashes the aircraft structure collapses and the individual is injured by impact with the airframe. These injuries can include amputations, major lacerations and crushing.’
When a plane slams into the ground or water, the sudden deceleration throws the body forward with violent force.
It’s in this instant that critical damage is done – not just to bones, but to vital organs.
Cullen’s research found that injuries to the chest – including the ribs, spine and sternum – occur in 80% of victims, typically from the torso striking restraints like seatbelts or hitting parts of the plane itself.
These broken bones often become lethal weapons.
In nearly half of the victims Cullen studied, their hearts were ruptured, and 35% had burst aortas (the body’s largest artery).
In some cases, the sharp ends of fractured ribs pierced the heart or blood vessels directly, causing devastating bleeding.
But more often, ‘it was the compression of the heart between the sternum and spine as the body became sandwiched in a seat that caused major internal bleeding.’
Spinal fractures were present in 45% of fatalities, a consequence of the body being jolted while locked in a seated position.
Pelvic injuries were similarly common, appearing in roughly the same proportion.
The head fares no better. Two-thirds of victims suffered head injuries, and in most of those cases, the trauma either caused or contributed to death.
Skull fractures – from striking the seat in front or flying debris – are especially deadly.
Inside the abdomen, the damage is often just as profound.
Cullen discovered that more than two-thirds of the victims studied had abdominal injuries, usually from ruptured solid organs like the liver, spleen and kidneys. These organs burst under pressure, leading to fatal internal bleeding.
When a plane becomes destabilized, even the contents inside can become deadly. ‘Overhead lockers are a particular source of loose items such as bottles that may cause significant injury,’ Cullen warned
Though seatbelts are life-saving in many crashes, Cullen also found they can cause injury. ‘Pivoting over a lap strap often produces tears in the lower part of the small bowel mesentery and other bowel injury. The restraints themselves may fail’
Many also suffered ruptured diaphragms, which can impair breathing – though not all such injuries are immediately fatal.
Limbs are rarely spared. Cullen found fractures in 80% of fatalities, with leg breaks in 73.6% and arm breaks in 56.6%.
These, too, reveal clues about how the body moved during the final seconds before death.
‘Fractures of the shin,’ he noted, occur when ‘the legs flail forward and strike fixed structures or are trapped under the seat in front of the victim.’
Miraculously, there was one survivor of the Air India crash, who emerged from the debris still able to walk.
Vishwash Kumar Ramesh, 40, was the sole survivor of Thursday’s devastating disaster after he was ‘ejected’ from the jet before the plane hit the ground and exploded.
The survivor, who lives in London with his wife, was travelling to Gatwick Airport in seat 11A by the exit following a business trip with his brother Ajaykumar Ramesh, 35, who sat on the other side of the aisle in seat 11J, and died in the explosion.
Astonishing footage showed Vishwash, who has reportedly sustained injuries to his chest, eyes and feet, hobble away from the scene of the crash.
Medical staff are currently treating him at a local hospital in Ahmedabad, where he told doctors that immediately after the plane took off, it began descending and suddenly splitting in two before there was a loud explosion.
Vishwash’s window seat was toward the front of the aircraft.
Experts agree there is no universally safe place to sit on a plane – every crash is different – but Cullen observed that in several incidents, the plane landed tail-first, putting passengers seated in the rear at greater risk.
For that reason, seats located above the wings – near the aircraft’s center of gravity – are often regarded as marginally safer, especially in nose- or tail-first impacts. These seats also tend to experience less turbulence.
Limbs are rarely spared in plane crashes. Cullen found fractures in 80% of fatalities, with leg breaks in 73.6% and arm breaks in 56.6%
Tony Cullen, who was a former international authority on aircraft accidents based out of the UK, spent decades investigating how deaths happen in plane crashes in a bid to improve safety in the skies
When a plane becomes destabilized, even the contents inside can become deadly.
‘Overhead lockers are a particular source of loose items such as bottles that may cause significant injury,’ Cullen warned.
‘Flying debris from overhead lockers was a major cause of head injury in the Boeing 737 disaster at Kegworth in January 1989.’
The Kegworth air disaster, also known as British Midland Flight 92, occurred when a Boeing 737-400 crashed near Kegworth in the UK killing 47 people and injuring 74 more.
The crash was caused by a combination of factors, including a fan blade failure on the left engine, a misdiagnosis by the pilots and a failure to properly follow checklists.
Though seatbelts are life-saving in many crashes, Cullen also found they can cause injury.
‘Pivoting over a lap strap often produces tears in the lower part of the small bowel mesentery and other bowel injury. The restraints themselves may fail.’
Pilots, too, suffer unique injuries.
Cullen noted that the positioning of their limbs at the moment of impact often leaves a forensic record.
‘Damage may occur in the hands and feet if they are on the controls at the moment of impact,’ he wrote.
‘The area between the thumb and index finger is particularly likely to be injured if the control column is being grasped.’
If the pilot’s feet are on the rudder pedals, ‘they are subjected to excessive force on the soles corresponding to the area of the pedals.’
Their heads may strike control panels – ‘leaving imprints on the forehead or face.’
One possible design evolution is already being quietly adopted: rear-facing seats in premium cabins.
Cullen supported the concept in his 2004 report, noting that ‘this seat configuration is generally safer in the event of a crash because the rear-facing seats offer better protection to the head and neck.’
Pilots, too, suffer unique injuries. Cullen noted that the positioning of their limbs at the moment of impact often leaves a forensic record
In the end, the legacy of Cullen’s work is not just forensic, it’s practical.
Understanding how and why passengers die in aviation disasters has helped improve airline safety protocols, cabin design and crash survivability.
One invention, which helps investigators massively, is the ‘black box’ developed by Dr. David Warren in the 1950s.
The device records flight data and crew conversations during the final moments before a crash.
But the grim biology of a crash remains a brutal testament to the immense forces at play when flight meets failure.
