Safety in the Skies, Master Volume: Personnel and Parties in NTSB Aviation Accident Investigations (original) (raw)
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Safety in the Skies: Personnel and Parties in NTSB Aviation Accident Investigations, 2000
Recent high-profile commercial aviation mishaps have stretched the National Transportation Safety Board's resources to the limit and are testing the agency's ability to unravel the sorts of complex failures that lead to tragic accidents. In recognizing the enormous challenges the NTSB faces, agency Chairman Jim Hall sought a critical examination of the NTSB's ability to investigate major transportation accidents, and in particular commercial aviation accidents. The results of that study are contained in this report, the most comprehensive examination of the workings of the NTSB in the 30-year history of the agency. Adopting a multidisciplinary approach, RAND used a variety of quantitative and qualitative research techniques to assess the NTSB's operations and processes. This research, conducted in the RAND Institute for Civil Justice, outlines recommendations aimed at strengthening the party process-which involves manufacturers, operators, and others in the determination of the probable cause of an accident expanding the statement of causation modernizing the NTSB's investigative procedures and streamlining its internal processes managing the agency's resources and staffing more effectively developing training opportunities for NTSB staff improving the agency's R&D facilities.
Air accident investigation among regulatory agencies
The aim of this manuscript is to describe and compare regulatory aviation agencies according to their subordination and attributions to investigate air accidents. Possible consequences in identifying the contributory factors are also presented. Distinct procedures investigating air accidents among agencies lead to a lack of standardization of the statistics, making it difficult to analyze the data globally. Separately the information does not configure the entire scenario of what occurred, affecting the analysis and subsequent interventions. We recommend a joint and collaborative work between the different committees that operate in the investigation of air accidents.
Flying is the safest way to travel: How aviation was a pioneer in independent accident investigation
European Journal of Transport and Infrastructure Research Ejtir 5, 2005
within the aviation sector throughout its history as a valuable tool to enhance safety. Such investigations enable the sector to learn by establishing the sequence of events that provides a satisfactory explanation of the accident leads to the drafting of recommendations to prevent reoccurrences. In addition, these investigations, which are publicly disseminated, encourage public confidence in the sector. Other transport sectors, including road, rail and water, have been slower in coming to enjoy the same acceptance of independent investigations; here, there is considerable variation amongst nations, and-with the exception of the International Civil Aviation Organization agreement-almost no international consistency. This article examines why aviation has had a different tradition in this regard. Reasons are found in parallel growth of aviation technology and the philosophy of investigative bodies, the inherently international aspect of commercial aviation, and the role of public and political pressure following major accidents. The safety investigative orientation of the aviation sector is gradually expanding to other transport sections and beyond that to other sectors such as fixed site production plants, health care, and management of natural disasters. With the newly installed Safety Investigation Board, the Netherlands has arguably placed itself at the head of this league table.
Modern Management Review, 2018
Statistics show that air transport is the safest mode of transport in the world. However, it should be remembered that it is also the most expensive form of transport. Complicated safety procedures, expressed inter alia in prevention related to the prevention and investigation of aviation events, place the greatest emphasis on the human factor in aviation. Maintaining the reliability ratio in air transport at a sufficiently high level, with the current increase in air transport, is a priority. This requires integrated activities of all entities involved in aviation activities. Aviation security is a general concept. Firstly, it covers problems related to operational safety (safety area). Secondly, protection problems of means of air transport and airport infrastructure protection against acts of unlawful interference (security area). The basic goal of aviation safety is to prevent all events related to the use of aircraft. One of the directions aimed at increasing aviation safety was the development and an implementation of the concept of a safety management system, which includes subsystems: processing and analysis of collected information enabling current examination of safety status, trends of changes and threat forecasts, assessment of the effectiveness of preventive and rescue projects, a bank of knowledge about events, exposures, safety status and the impact of individual factors on safety. Today we can say that a high security level has been achieved in air transport, as well as in services and in aviation training. It became possible due to the intensive, systematic and continuous work of aviation authorities and organizations.
New European Union Approach to Civil Aviation Accident Investigation and Prevention
Journal of Aircraft, 2012
Civil aviation has a long-standing tradition of investigating accidents, which contributes to making aviation one of the safest forms of transport. The obligation to investigate accidents is enshrined in the Chicago Convention of 1944. Recognizing the importance of accident investigation, the European Union adopted the principles governing the investigation of civil aviation accidents. But the European Union rules on investigating air accidents need to be updated to reflect the current realities of Europe's aviation market and the complexity of the global aviation industry. Accordingly, the European Commission has been working on a regulation on the investigation and prevention of accidents and incidents in civil aviation. Reasons behind this new regulation are presented in this paper, together with a detailed explanation of its main contents, an assessment of their impact, and their expected benefits.
Accident Analysis and Prevention, 2009
The objective of this paper is to discuss the following questions: Do concurrent organizational changes have a direct impact on aviation maintenance and safety, if so, how can this be measured? These questions were part of the investigation carried out by the Accident Investigation Board, Norway (AIBN). The AIBN investigated whether Norwegian aviation safety had been affected due to major organizational changes between 2000 and 2004. The main concern was the reduction in safety margins and its consequences. This paper presents a summary of the techniques used and explains how they were applied in three airlines and by two offshore helicopter operators. The paper also discusses the development of safety related indicators in the aviation industry. In addition, there is a summary of the lessons learned and safety recommendations. The Norwegian Ministry of Transport has required all players in the aviation industry to follow up the findings and recommendations of the AIBN study.
Development of Rating Instruments and Procedures for Aviation Mishap Investigation
This report has been cleared for release to the Defense Technical Information Center (DTIC) to comply with regulatory requirements. It has been given no primary distribution other than to DTIC and will be available only through DTIC or the National Technical Information Service (NTIS). o FINAL DISPOSITION: This report may be destroyed when it is no longer needed. Please do not return it to the U.S. Army Research Institute for the Behavioral and Social Sciences. NOTE: The views, opinions, and findings in this report are those of the author(s) and should not be construed as an official Department of the Army position, policy, or decision, unless so designated by other authorized documents.
This dissertation examined pilot behavioral traps in the multi-crew Part 121 air carrier environment. Behavioral traps are accident-inducing operational pitfalls aviators may encounter as a result of poor decision making. The traps studied were: Loss of Situational Awareness; Neglect of Flight Planning, Preflight Inspections and Checklists; Peer Pressure; Get-There-Itis; and Unauthorized Descent Below an Instrument Flight Rule (IFR) Altitude. The purpose of this dissertation was to study the nature of their occurrence in the airline domain. Another key component was to explore the relationships between the behavioral traps and factors such as pilot age, pilot flight experience, weather, flight conditions, time of day, and the first officer certification level. The dissertation was conducted using an archival combined-methods methodology. Four subject matter experts analyzed 34 National Transportation Safety Board (NTSB) accident reports. Behavioral traps were found in all accidents with Loss of Situational Awareness and Neglect of Flight Planning, Preflight Inspections, and Checklists dominant. The SMEs were able to identify many pilot actions that were representative of the behavioral traps. iv During the qualitative analysis, various themes began to emerge which played important roles in many accidents. These emerging themes were Crew Resource Management issues, Fatigue, Airline Management, and Flying Outside the Envelope. The quantitative analysis discovered a moderate correlation, r = -.34, p = .05, between the Captain's Flight Experience and the behavioral trap Unauthorized Descent Below an IFR Altitude. No other correlations were found to be significant between the variables and the behavioral traps. The findings of this study indicated that behavioral traps were prevalent in airline accidents including habitual noncompliance by pilots. Further research should focus on other flight domains and other informational sources such as air taxi operators, incident accounts, and flight recorded data. Attitude management training is recommended. v DEDICATION My journey to a doctoral degree began more than four years ago. This dissertation is dedicated to Amos. I trust the time and effort spent completing this manuscript was part of your plan. With your guidance, everything is possible. To my parents, Israel Velázquez and Sonia I. Rivera, who inspired me to persevere and pursue the highest goals in life. Without their moral and financial support, the road and destination would have been different.