TY - RPRT AN - 01626718 AU - National Transportation Safety Board TI - Safety Recommendation Report: Uncommanded Nosewheel Steering Anomalies During Landing in Embraer EMB-145 Regional Jets PY - 2017/01/26 SP - 7p AB - The National Transportation Safety Board (NTSB) is issuing two safety recommendations to Embraer and three safety recommendations to the Federal Aviation Administration (FAA) as a result of the investigation of several runway excursion events involving uncommanded nosewheel steering anomalies during landing in Embraer EMB-145 regional jets. Recommendations to Embraer: (1) In cooperation with Parker Aerospace and Woodward HRT, study and revise the acceptance test procedures for the nosewheel steering manifold assembly and electrohydraulic servo valve on Embraer EMB-135, EMB-140, and EMB-145 aircraft to adequately identify any foreign object debris that may be present. (2) Issue an operations bulletin informing your operators that the use of binder brackets to hold chart binders is not approved by Embraer and could cause a hazardous condition if a binder becomes dislodged from the bracket. Recommendations to the FAA: (1) Review Woodward HRT’s manufacturing process and quality control program for the electrohydraulic servo valve and require improvements to eliminate manufacturing or assembly errors and nonconformances that could cause uncommanded nosewheel steering anomalies in Embraer EMB-135, EMB-140, and EMB-145 aircraft; and (2) monitor and verify the effectiveness of any improvements. (2) After Embraer issues the operations bulletin as recommended in Safety Recommendation A-17-3, notify operators of Embraer aircraft that the use of binder brackets to hold chart binders could cause a hazardous condition if a binder becomes dislodged from the bracket and encourage operators to comply with the Embraer operations bulletin. (3) Require operators of Embraer EMB-135, EMB-140, and EMB-145 airplanes to incorporate training for uncommanded swerving on landing in their initial and recurrent simulator training programs. KW - Air transportation crashes KW - Aviation safety KW - Brackets KW - Crash investigation KW - Embraer aircraft KW - Landing KW - Recommendations KW - Regional jets KW - Runway overruns KW - Steering wheels UR - https://www.ntsb.gov/investigations/AccidentReports/Reports/ASR1702.pdf UR - https://trid.trb.org/view/1455203 ER - TY - RPRT AN - 01626605 AU - National Transportation Safety Board TI - Marine Accident Brief: Capsizing and Sinking of Towing Vessel Ricky J Leboeuf PY - 2017/01/23 SP - 8p AB - About 0752 local time on April 19, 2016, the uninspected towing vessel Ricky J Leboeuf capsized and later sank while attempting to remove a barge from a fleeting area in the San Jacinto River near Channelview, Texas. Four of the five crewmembers survived, but one deckhand died. The vessel sustained an estimated $900,000 in damage, rendering it a constructive total loss. Less than 100 gallons of diesel oil, lubricating oil, and other contaminants were released into the river when the vessel sank. The National Transportation Safety Board determines that the probable cause of the capsizing and sinking of the towing vessel Ricky J Leboeuf was the relief captain’s ill-advised decision to perform a downstreaming maneuver in high water conditions without implementing the operating company’s risk mitigation strategies or other safeguards. KW - Capsizing KW - Channelview (Texas) KW - Crash causes KW - Crash investigation KW - Fatalities KW - Ship pilotage KW - Towboats KW - Water transportation crashes UR - https://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1704.pdf UR - https://trid.trb.org/view/1455205 ER - TY - RPRT AN - 01626517 AU - National Transportation Safety Board TI - Safety Recommendation Report: Unsafe Wiring Conditions in Piper Model PA-31T-Series Airplane Floor-Mounted Circuit Breaker Panels PY - 2017/01/05 SP - 3p AB - The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) to take urgent action on the safety recommendation in this report. This recommendation is intended to detect and correct unsafe wiring conditions that could lead to chafing, thermal stress, or arcing in the area directly below the floor-mounted circuit breaker panel in Piper Aircraft, Inc. model PA-31T-series airplanes. It is derived from an ongoing investigation of an accident in which a Piper PA-31T broke up in flight and crashed shortly after the pilot reported smoke in the cockpit. The accident occurred July 29, 2016 near McKinleyville, California. As a result of preliminary findings in this investigation, the NTSB is issuing one urgent safety recommendation to the FAA. KW - Air transportation crashes KW - Airplanes KW - Aviation safety KW - Circuit breakers KW - Piper aircraft KW - Recommendations KW - U.S. Federal Aviation Administration KW - Wiring UR - https://www.ntsb.gov/investigations/AccidentReports/Reports/ASR1701.pdf UR - https://trid.trb.org/view/1447171 ER - TY - RPRT AN - 01626781 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Bulk Carrier Aris T with Tank Barge WTC 3019, Towing Vessel Pedernales, and Shoreside Structures PY - 2017/01/04 SP - 12p AB - On January 31, 2016, at 1953 local time, bulk carrier Aris T collided with tank barge WTC 3019, towing vessel Pedernales, and two facility structures, all of which were located on the left descending bank of the Mississippi River between mile marker (mm) 125.2 and mm 126.0 at Norco, Louisiana. Also damaged during the collision were one additional shoreside structure, another towing vessel, and two other tank barges, bringing the total damage cost to more than $60 million. No pollution resulted from the accident; however, two dock workers reported injuries. The National Transportation Safety Board determined that the probable cause of the collision of bulk carrier Aris T with tank barge WTC 3019, towing vessel Pedernales, and shoreside structures was the failure of the pilot on the Aris T to take early and effective action to mitigate the risk presented by the developing upriver traffic situation, and the distraction of the captain on the Loretta G. Cenac from safety-critical navigational functions as a result of his cell phone use. KW - Bulk carriers KW - Cellular telephones KW - Crash causes KW - Crash investigation KW - Distraction KW - Mississippi River KW - Norco (Louisiana) KW - Tank barges KW - Towboats KW - Water transportation crashes UR - https://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1701.pdf UR - https://trid.trb.org/view/1447172 ER - TY - RPRT AN - 01619997 AU - National Transportation Safety Board TI - Railroad Accident Brief: Norfolk Southern Railway Employee Fatality, New Orleans, Louisiana, February 20, 2016 PY - 2016/12/14 SP - 3p AB - On February 20, 2016, about 6:10 a.m., Norfolk Southern Railway Company (NS) train 298 struck and killed a NS terminal trainmaster in New Orleans, Louisiana. The train was operating on main track 2 at milepost 186 of the Alabama division, NE subdivision. At the time of the accident, the trainmaster was most likely placing a shunt on main track 2 to perform a train-crew efficiency test. The National Weather Service had issued a dense fog advisory for the area from 4:00 a.m. until 9:00 a.m. on the day of the accident. Visibility was reported as 1/4 mile in dense fog. The National Transportation Safety Board determines that the probable cause of the accident was the trainmaster not detecting the presence of an oncoming train and removing himself from main track 2 for unknown reasons. KW - Fatalities KW - Fog KW - New Orleans (Louisiana) KW - Norfolk Southern Railway Company KW - Occupational safety KW - Railroad crashes KW - Railroad safety KW - Visibility distance UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1607.pdf UR - https://trid.trb.org/view/1440528 ER - TY - RPRT AN - 01619018 AU - National Transportation Safety Board TI - Railroad Accident Brief: Derailment of WMATA Metrorail Train in Interlocking, Falls Church, Virginia, July 29, 2016 PY - 2016/12/01 SP - 11p AB - On July 29, 2016, about 6:14 a.m. eastern daylight time, outbound (westbound) Washington Metropolitan Area Transit Authority (WMATA) Metrorail train 602 derailed while traversing a crossover in the East Falls Church interlocking, operating on the Silver Line in Falls Church, Virginia. About 63 passengers were on board the six-car passenger train, all of whom were evacuated out of the lead car, assisted by the Metro Transit Police Department. Three passengers reported injuries, including one who was hospitalized. ​The National Transportation Safety Board determines that the probable cause of this accident was a wide track gage condition resulting from the sustained use of deteriorating wooden crossties due to Washington Metropolitan Area Transit Authority’s ineffective inspection and maintenance practices and inadequate safety oversight. KW - Crash causes KW - Crash investigation KW - Derailments KW - Falls Church (Virginia) KW - Gage (Rails) KW - Maintenance of way KW - Metrorail (Washington Metropolitan Area) KW - Railroad crashes KW - Railroad safety KW - Railroad ties UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1606.pdf UR - https://trid.trb.org/view/1437083 ER - TY - RPRT AN - 01618146 AU - National Transportation Safety Board TI - Safety Recommendation Report: Educating Controllers on Two Midair Collisions PY - 2016/11/14 SP - 5p AB - The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) and Midwest Air Traffic Control, Robinson Aviation, and Serco (companies that operate federal contract towers) to take action on the safety recommendations in this report. These recommendations address educating air traffic controllers on the circumstances of the July 7, 2015, Moncks Corner, South Carolina and August 16, 2015, San Diego, California midair collisions in which the air traffic controllers made judgment errors that led to the collisions. As a result of these investigations, the NTSB is issuing two safety recommendations each to the FAA, Midwest Air Traffic Control, Robinson Aviation, and Serco. KW - Air traffic control KW - Air traffic controllers KW - Aviation safety KW - Crash causes KW - Midair crashes KW - Moncks Corner (South Carolina) KW - Recommendations KW - San Diego (California) UR - http://ntsb.gov/investigations/AccidentReports/Reports/ASR1606.pdf UR - https://trid.trb.org/view/1435224 ER - TY - RPRT AN - 01618148 AU - National Transportation Safety Board TI - Railroad Accident Brief: Canadian National Railway Employee Fatality, Homewood, Illinois, July 25, 2015 PY - 2016/11/10 SP - 5p AB - On July 25, 2015, at 8:36 a.m. central daylight time, a Canadian National Railway Company (CN) yard conductor died after he tripped, slipped, or fell while trying to board a train. He was working at the CN Markham Yard in Homewood, Illinois. The crew included a locomotive engineer, a conductor (the deceased), a brakeman, and a utility man; train R96991-25 consisted of two locomotives and 12 cars. The weather was clear and sunny with a temperature of 76°F. The National Transportation Safety Board determines that the probable cause of the accident was that the conductor slipped, tripped, or fell during his attempt to board locomotive GTW 4927 as it passed at 12.5 mph, which is three times the maximum authorized speed to board moving equipment. KW - Canadian National Railways KW - Conductors (Trains) KW - Crash causes KW - Crash investigation KW - Fatalities KW - Homewood (Illinois) KW - Occupational safety KW - Railroad crashes KW - Railroad safety KW - Yard operations UR - http://ntsb.gov/investigations/AccidentReports/Reports/RAB1605.pdf UR - https://trid.trb.org/view/1435223 ER - TY - RPRT AN - 01616879 AU - National Transportation Safety Board TI - Railroad Accident Brief: BNSF Railway Employee Fatality, Minneapolis, Minnesota, May 25, 2015 PY - 2016/10/27 SP - 9p AB - On May 25, 2015, at 11:39 a.m. central daylight time, a BNSF Railway engineering department foreman died while directing the unloading of track panels from flat cars located on a side track adjacent to a main track. While the foreman directed the work from one of the flat cars, the machine operator was attempting to unload two track panels; however one panel slid off the fork lift and struck two locomotives passing on the adjacent main track. The foreman jumped or fell from the flat car to the ground just as the falling panel struck a panel on the flat car forcing it to slide onto the foreman below. The accident occurred near milepost (MP) 9.7 on the BNSF Midway Subdivision in Minneapolis, Minnesota. The passing locomotive was operating at 13 miles per hour (mph). The temperature at the time of the accident was 63° F with wind of 17 mph. ​The National Transportation Safety Board determines that the probable cause of the accident was the locomotive on an adjacent track striking track panels being unloaded and causing them to dislodge and fall on the foreman. Contributing to the accident was (1) a job briefing that did not address the risks associated with the work; (2) the continuation of unloading activities despite being alerted to an approaching train on the adjacent main track; and (3) unclear guidance on adjacent track protection. KW - BNSF Railway KW - Crash causes KW - Crash investigation KW - Fatalities KW - Minneapolis (Minnesota) KW - Occupational safety KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1604.pdf UR - https://trid.trb.org/view/1428234 ER - TY - RPRT AN - 01616883 AU - National Transportation Safety Board TI - Marine Accident Brief: Towing by Coast Guard Cutter Kiska of Recreational Vessel Kolina, Resulting in Loss of Life, Alenuihaha Channel South of Maui, Hawaii, November 5, 2015 PY - 2016/10/03 SP - 13p AB - ​On November 5, 2015, about 2305, the crew aboard the 110-foot-long US Coast Guard cutter Kiska lost radio contact with the captain of the 30-foot-long recreational vessel Kolina. At the time, the cutter was towing the recreational vessel in the Alenuihaha Channel, about 26 nautical miles (nm) south of Maui, Hawaii, after the Kolina captain had requested aid due to a broken tiller. The Coast Guard began a search-and-rescue/person-in-the-water mission to locate the captain. At 0917 on November 6, the captain was found in the water underneath the Kolina, entangled in the mast rigging and unresponsive. The Kolina sank about 10 hours after the body was retrieved. The National Transportation Safety Board determines that the probable cause of the accident involving Coast Guard cutter Kiska and recreational vessel Kolina, with the death of the Kolina captain, was the Kolina captain’s decision to launch and operate a poorly maintained vessel and his failure to protect his personal safety during the subsequent tow in the Alenuihaha Channel. KW - Crash investigation KW - Fatalities KW - Maui (Hawaii) KW - Search and rescue operations KW - Shipboard personnel KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1619.pdf UR - https://trid.trb.org/view/1427758 ER - TY - RPRT AN - 01613761 AU - National Transportation Safety Board TI - Railroad Accident Brief: Norfolk Southern Employee Fatality During Switching Operations, Petal, Mississippi, August 12, 2015 PY - 2016/09/28 SP - 6p AB - On August 12, 2015, at 10:39 p.m., central daylight time, a Norfolk Southern Railway Company (NS) conductor trainee working at the Lone Star Gas facility (H 82) on the NS Alabama Division in Petal, Mississippi, was killed when he was pinned between two tank cars that were being coupled on the industry track. The weather at the time of the accident was 77°F and partly cloudy. The accident occurred inside the Lone Star liquefied petroleum gas (LPG) transloading facility in Petal, Mississippi, about 5 miles east of Hattiesburg. H 82 was east of the NS main track, a siding track, and a back track. Train movements on the main track were authorized by track warrants and governed by operating rules, general orders, timetable instructions, and the signal indications of an absolute block system. The National Transportation Safety Board determines that the probable cause of the accident was the conductor trainee stepping in between two tank cars without protection for an unknown reason during the shove movement. KW - Conductors (Trains) KW - Crash causes KW - Crash investigation KW - Fatalities KW - Norfolk Southern Railway Company KW - Occupational safety KW - Petal (Mississippi) KW - Railroad crashes KW - Railroad safety KW - Switching UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1602.pdf UR - https://trid.trb.org/view/1425485 ER - TY - RPRT AN - 01614872 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Barge Gayle Force, Under Tow by Tugboat Simone, with Norfolk Southern Bridge #7, Chesapeake, Virginia, April 26, 2015 PY - 2016/09/14 SP - 8p AB - At 0720 on April 26, 2015, the barge Gayle Force struck the unmanned Norfolk Southern Railway Bridge #7 (NS#7) on the Southern Branch of the Elizabeth River in Chesapeake, Virginia, while being towed by the tugboat Simone. The allision caused $1.8 million in damage to the bridge and stopped rail traffic for nearly 36 hours. Damage to the barge was negligible. No one was injured, and there was no pollution associated with the accident. ​The National Transportation Safety Board determines that the probable cause of the allision of the barge Gayle Force with the Norfolk Southern Bridge #7 was the Simone captain’s failure to plan for the bridge transit and effectively use the assist tugboat. KW - Allisions KW - Barges KW - Chesapeake (Virginia) KW - Crash causes KW - Crash investigation KW - Marine safety KW - Towboats UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1616.pdf UR - https://trid.trb.org/view/1426278 ER - TY - RPRT AN - 01616903 AU - National Transportation Safety Board TI - An Assessment of the Effectiveness of the US Coast Guard Vessel Traffic Service System PY - 2016/09/13/Safety Study SP - 100p AB - The US Coast Guard (the Coast Guard) vessel traffic service (VTS) is a shore-based surveillance and communications system with the authority to ensure the safe and efficient movement of vessel traffic in particularly hazardous or congested waterways in the United States. The system’s primary mission is to reduce the risk of collisions, allisions, and groundings. To do this effectively, the system must be able to detect and resolve unsafe traffic situations in a timely manner. There are 12 Coast Guard VTS centers that make up the VTS system, and each center is responsible for managing the traffic that operates inside its designated VTS area. Since 1994, participation in this system has been mandatory for most types of power-driven commercial vessels, towing vessels, and dredge platforms while operating inside a Coast Guard VTS area. During the years 2010 through 2014, an average of 18% of all reportable collisions, allisions, and groundings involving vessels meeting the requirements of a VTS user occurred while they were operating inside a VTS area. The most common causal factor assigned to these accidents by the Coast Guard was inattention errors by the mariners involved, which suggests that an opportunity exists for the VTS system to further reduce the risk of these types of accidents by taking a more proactive role in traffic management. In this study, the National Transportation Safety Board (NTSB) examined the Coast Guard VTS system’s ability to (1) detect and recognize traffic conflicts and other unsafe situations, (2) provide mariners with timely warning of such traffic conflicts and unsafe situations, and (3) control vessel traffic movements in the interest of safety. KW - Detection and identification systems KW - Evaluation and assessment KW - Incident detection KW - Marine safety KW - Recommendations KW - Risk management KW - Traffic conflicts KW - Training KW - Trend (Statistics) KW - U.S. Vessel Traffic Service KW - United States Coast Guard KW - Vessel traffic control KW - Water transportation crashes UR - http://www.ntsb.gov/safety/safety-studies/Documents/SS1601.pdf UR - https://trid.trb.org/view/1427162 ER - TY - RPRT AN - 01610844 AU - National Transportation Safety Board TI - Safety Recommendation Report: Emergency Training for Air Traffic Controllers PY - 2016/08/25 SP - 9p AB - This document examines five aviation accidents and the role of the air traffic controller in providing effective emergency assistance or protecting against the deterioration of problems into emergencies. Crashes examined included: a Cessna 152 in New Smyrna Beach, Florida, January 13, 2015; a Piper PA-32RT-300T, N39965, Hugheston, West Virginia, April 11, 2014; a Beechcraft H35, N375B, Palm Coast, Florida, January 4, 2013; a Piper PA-28-160, N5714W, Parkton, North Carolina, December 16, 2012; and a Beechcraft V35B, N11JK, Effingham, South Carolina, August 11, 2012. The National Transportation Safety Board (NTSB) concluded that, based on these accidents, current training provided to air traffic controllers is not effective in preparing them to provide appropriate assistance to aircraft in distress. The NTSB further concluded that recurrent national training for controllers specifically addressing the identification of common emergencies, illustrated with current, real-life examples, and explaining how best to help pilots facing such events would ensure that controllers are well equipped to help pilots in emergency situations. KW - Air traffic controllers KW - Air transportation crashes KW - Aviation safety KW - General aviation aircraft KW - Recommendations KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/ASR1604.pdf UR - https://trid.trb.org/view/1422937 ER - TY - RPRT AN - 01608601 AU - National Transportation Safety Board TI - Highway Accident Brief: Passenger Vehicle/School Bus Collision and Roadway Departure, Houston, Harris County, Texas, September 15, 2015 PY - 2016/07/20 SP - 15p AB - On Tuesday, September 15, 2015, about 7:03 a.m. local time, a 47-passenger 2009 International school bus, operated by the Houston Independent School District (HISD) and occupied by a 44-year-old female driver and four HISD students aged 14 to 17, was traveling eastbound on South Loop East Freeway (I-610) in lane 3 of the four-lane limited access highway at an estimated speed of 55 mph. The school bus had entered eastbound I-610 at South Wayside Drive and was en route to Furr High School. After traveling approximately 1 mile on eastbound I-610, the school bus approached the overpass above Telephone Road. About the same time, a 2004 Buick LeSabre passenger vehicle, driven by a 29 year-old female, was traveling eastbound in lane 2 on I-610 at an estimated speed of 69 mph. As the Buick overtook the school bus, it departed lane 2 to the right and collided with the school bus in lane 3. The Buick struck the school bus near the bus’s left front wheel. The school bus moved to the right, departed lane 3, traversed lane 4 and the right shoulder, and struck the bridge rail at an approximate 28 degree angle. The bus overrode the concrete portion of the bridge rail and breached the metal railing along the top of the concrete parapet, leaving an approximately 3 foot long opening in the metal rail, before falling approximately 21 feet onto Telephone Road. The bus came to rest on its left side facing westward on the east side of Telephone Road. The Buick came to rest on the right shoulder of I-610 beyond the overpass. As a result of the crash, two student passengers on the bus died, and the remaining two students received serious injuries. The driver of the HISD school bus received serious injuries. The driver of the Buick was not injured. The National Transportation Safety Board determines that the probable cause of the Houston, Texas, crash was the Buick LeSabre driver’s intrusion into a lane occupied by a Houston Independent School District school bus. Contributing to the severity of the crash was the failure of the bridge railing to redirect the school bus because the dynamics of the collision exceeded the design capabilities of the railing. KW - Bridge railings KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Houston (Texas) KW - Ran off road crashes KW - School buses UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1605.pdf UR - https://trid.trb.org/view/1419012 ER - TY - RPRT AN - 01608573 AU - National Transportation Safety Board TI - Safety Recommendation Report: Improving Pilot and Aviation Medical Examiner Knowledge of Cataract Hazards PY - 2016/07/11 SP - 5p AB - The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) and the Aircraft Owners and Pilots Association (AOPA) to take action on the safety recommendations in this report. These recommendations address the flight safety of pilots who develop cataracts. These recommendations are derived from the NTSB’s investigation of a December 26, 2013, fatal aircraft accident in Fresno, California, involving a pilot with progressive cataracts who had demonstrated recent difficulty landing his airplane at night but was able to pass FAA medical certification vision testing. The NTSB has determined there is limited educational information provided to pilots and aviation medical examiners (AME) concerning the hazards cataracts pose to flight safety, especially at night. As a result, the NTSB is issuing two recommendations to the FAA and one recommendation to AOPA. KW - Air pilots KW - Air transportation crashes KW - Aircraft Owners and Pilots Association KW - Aviation safety KW - Cataracts KW - Certification KW - Diseases and medical conditions KW - Recommendations KW - U.S. Federal Aviation Administration KW - Vision disorders UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/ASR1603.pdf UR - https://trid.trb.org/view/1417467 ER - TY - RPRT AN - 01608540 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision between US Coast Guard Cutter Key Largo and Fishing Vessel Sea Shepherd, with Subsequent Sinking of Sea Shepherd PY - 2016/07/11 SP - 9p AB - On September 23, 2014, about 0635, the 110-foot-long US Coast Guard cutter Key Largo collided with the 42-foot-long fishing vessel Sea Shepherd in the Virgin Passage, about 9 miles east-northeast of Vieques Island, Puerto Rico. Just before the collision, the two Sea Shepherd crewmembers, who were hauling lobster traps on board, jumped in the water. No one was injured. The Key Largo sustained minor damage; the Sea Shepherd sank about 2 hours after the collision. The National Transportation Safety Board determines that the probable cause of the collision between the Coast Guard cutter Key Largo and the fishing vessel Sea Shepherd was the failure of the cutter’s officer of the deck to detect and avoid the Sea Shepherd, most likely because he had fallen asleep prior to the accident. Contributing to the collision was the officer of the deck’s failure to report to the commanding officer his unfitness for duty due to lack of sleep. KW - Crash causes KW - Crash investigation KW - Fatigue (Mechanics) KW - Fishing vessels KW - Maritime safety KW - Vieques (Puerto Rico) KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1609.pdf UR - https://trid.trb.org/view/1417469 ER - TY - RPRT AN - 01605715 AU - National Transportation Safety Board TI - Marine Accident Brief: Capsizing and Sinking of Fishing Vessel Hawaii Five-1 PY - 2016/06/30 SP - 7p AB - On November 25, 2015, at 1158, the uninspected fishing vessel Hawaii Five-1, en route to Honolulu, Hawaii, from Bayou La Batre, Alabama, capsized and subsequently sank in the Gulf of Mexico just north of the Straits of Yucatan. The two crewmembers, a captain and a deckhand, managed to board a liferaft and were rescued by the Coast Guard later that night. The crew reported minor injuries associated with the accident. The National Transportation Safety Board determines that the probable cause of the capsizing and sinking of fishing vessel Hawaii Five-1 was inadequate intact stability due to the owners’ failure to determine and mitigate the impacts that the conversion to longline fisheries services had on the vessel’s overall stability. Contributing to the loss of the vessel was the master’s insufficient understanding of stability principles, as demonstrated by his lack of action to improve the vessel’s stability during adverse sea conditions, and his failure to maintain watertight integrity. KW - Capsizing KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Gulf of Mexico KW - Maritime safety KW - Stability (Mechanics) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1607.pdf UR - https://trid.trb.org/view/1415975 ER - TY - RPRT AN - 01604111 AU - National Transportation Safety Board TI - Marine Accident Report: Collision between Bulk Carrier Conti Peridot and Tanker Carla Maersk, Houston Ship Channel near Morgan’s Point, Texas, March 9, 2015 PY - 2016/06/20 SP - 40p AB - On March 9, 2015, at 1230 central daylight time, the inbound bulk carrier Conti Peridot collided with the outbound tanker Carla Maersk in the Houston Ship Channel near Morgan’s Point, Texas. The collision occurred in restricted visibility after the pilot on the Conti Peridot was unable to control the heading fluctuations that the bulk carrier was experiencing during the transit. As a result, the Conti Peridot crossed the channel into the path of the Carla Maersk. No one on board either ship was injured in the collision, but an estimated 2,100 barrels (88,200 gallons) of methyl tert-butyl ether spilled from the Carla Maersk, and the two vessels sustained about $8.2 million in total damage. The National Transportation Safety Board determines that the probable cause of the collision between bulk carrier Conti Peridot and tanker Carla Maersk in the Houston Ship Channel was the inability of the pilot on the Conti Peridot to respond appropriately to hydrodynamic forces after meeting another vessel during restricted visibility, and his lack of communication with other vessels about this handling difficulty. Contributing to the circumstances that resulted in the collision was the inadequate bridge resource management between the master and the pilot on the Conti Peridot. KW - Bulk carriers KW - Crash causes KW - Crash investigation KW - Houston Ship Channel KW - Tankers KW - Visibility distance KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1601.pdf UR - https://trid.trb.org/view/1413293 ER - TY - RPRT AN - 01604106 AU - National Transportation Safety Board TI - Aircraft Accident Report: Aerodynamic Stall and Loss of Control During Approach, Embraer EMB-500, N100EQ, Gaithersburg, Maryland, December 8, 2014 PY - 2016/06/07 SP - 71p AB - This report discusses the December 8, 2014, accident in which an Embraer EMB-500 airplane (marketed as the Phenom 100), N100EQ, registered to and operated by Sage Aviation LLC, crashed while on approach to runway 14 at Montgomery County Airpark, Gaithersburg, Maryland. The airplane impacted three houses and the ground about 3/4 mile from the approach end of the runway. A postcrash fire involving the airplane and one of the three houses, which contained three occupants, ensued. The pilot, the two passengers, and the three people in the house died as a result of the accident. The airplane was destroyed by impact forces and postcrash fire. Safety issues relate to the need for a system that provides automatic alerting when ice protection systems should be activated on turbofan airplanes that require a type rating and are certified for single-pilot operations and flight in icing conditions, such as the EMB-500; and the need for training for pilots of these airplanes beyond what is required to pass a check ride. The National Transportation Safety Board (NTSB) determines that the probable cause of this accident was the pilot’s conduct of an approach in structural icing conditions without turning on the airplane’s wing and horizontal stabilizer deice system, leading to ice accumulation on those surfaces, and without using the appropriate landing performance speeds for the weather conditions and airplane weight, as indicated in the airplane’s standard operating procedures, which together resulted in an aerodynamic stall at an altitude at which a recovery was not possible. Safety recommendations are addressed to the Federal Aviation Administration, the General Aviation Manufacturers Association, and the National Business Aviation Association. KW - Air transportation crashes KW - Approach KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fires KW - Gaithersburg (Maryland) KW - Icing KW - Loss of control KW - Stall UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1601.pdf UR - https://trid.trb.org/view/1413294 ER - TY - RPRT AN - 01603630 AU - National Transportation Safety Board TI - Railroad Accident Report: Derailment of Amtrak Passenger Train 188, Philadelphia, Pennsylvania, May 12, 2015 PY - 2016/05/17 SP - 70p AB - At 9:21 p.m. eastern daylight time on May 12, 2015, eastbound Amtrak passenger train 188 derailed in Philadelphia, Pennsylvania, with 245 passengers and 8 Amtrak employees on board. The train had just entered the Frankford Junction curve—where the speed is restricted to 50 mph—at 106 mph. As the train entered the curve, the locomotive engineer applied the emergency brakes. Seconds later, the train derailed. Eight passengers died, and 185 others were transported to area hospitals. This report addresses the following safety issues: crewmember situational awareness and management of multiple tasks; positive train control; passenger railcar window systems and occupant protection; and transportation of the injured after mass casualty incidents. The National Transportation Safety Board (NTSB) determines that the probable cause of the accident was the engineer’s acceleration to 106 mph as he entered a curve with a 50 mph speed restriction, due to his loss of situational awareness likely because his attention was diverted to an emergency situation with another train. Contributing to the accident was the lack of a positive train control system. Contributing to the severity of the injuries were the inadequate requirements for occupant protection in the event of a train overturning. As a result of the investigation of this accident, the NTSB makes recommendations to Amtrak, the Federal Railroad Administration, the American Public Transportation Association, the Association of American Railroads, the Philadelphia Police Department, the Philadelphia Fire Department, the Philadelphia Office of Emergency Management, the mayor of the city of Philadelphia, the National Association of State EMS (Emergency Medical Services) Officials, the National Volunteer Fire Council, the National Emergency Management Association, the National Association of EMS Physicians, the International Association of Chiefs of Police, and the International Association of Fire Chiefs. KW - Amtrak KW - Crash causes KW - Derailments KW - Distraction KW - Emergency medical services KW - Fatalities KW - Occupant protection devices KW - Philadelphia (Pennsylvania) KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Speeding UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1602.pdf UR - https://trid.trb.org/view/1411932 ER - TY - SER AN - 01600769 JO - Highway accident report PB - National Transportation Safety Board AU - National Transportation Safety Board TI - Highway Accident Brief: Collision of Two School Buses with Subsequent Rollover, Knoxville, Knox County, Tennessee, December 2, 2014 PY - 2016/05/05 SP - 10p AB - On Tuesday, December 2, 2014, about 2:52 p.m. eastern standard time, a 2001 Thomas Built transit-style school bus, identified as bus #57, was transporting 18 students and an adult teacher’s aide from Sunny View Primary School in Knoxville, Knox County, Tennessee. The bus was traveling westbound in the left lane of Asheville Highway and had just crossed the intersection with John Sevier Highway (East). In the meantime, a 2000 Navistar International transit-style school bus, identified as bus #44, was traveling eastbound in the left lane of Asheville Highway transporting 22 students from Chilhowee Intermediate School. As bus #44 approached the signalized intersection with John Sevier Highway, traffic in front of the bus was stopped at the intersection. The driver of bus #44 swerved left to avoid the stopped traffic and crossed a 30-foot-wide painted median into the westbound lanes of Asheville Highway. The front of bus #44 collided with the left (driver) side of bus #57. Following the initial impact, bus #57 rotated counter-clockwise (about 90 degrees); the vehicle partially departed the roadway, slid onto the shoulder, and collided with a barricade made of five steel poles embedded in a concrete curb, before overturning onto its right side. As a result of the crash, the adult teacher’s aide, who was reportedly seated on the left side near the rear axle of bus #57, died. Additionally, two student passengers seated near the impact zone on the left side of bus #57 received fatal injuries. Occupants of both vehicles received injuries of varying degrees. The National Transportation Safety Board (NTSB) initiated a field investigation of this crash with an emphasis on the human performance issues related to distracted vehicle operation. ​The National Transportation Safety Board determines that the probable cause of the December 2, 2014, collision between two school buses near Knoxville, Tennessee, was the late reaction and subsequent loss of control by the driver of bus #44 when he swerved to avoid traffic stopped ahead of him due to distraction caused by his reading a text message on his cell phone while driving. Contributing to the severity of the injuries were the crash dynamics and interaction between school bus #44 and school bus #57, resulting in school bus #57 rotating counter-clockwise approximately 90 degrees and subsequently striking a barricade before overturning onto its side, causing the passengers to be displaced from their seating positions. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Distraction KW - Fatalities KW - Highway safety KW - Knoxville (Tennessee) KW - Rollover crashes KW - School buses KW - Text messaging UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB-16-04.pdf UR - https://trid.trb.org/view/1409212 ER - TY - RPRT AN - 01603671 AU - National Transportation Safety Board TI - Railroad Accident Report: Washington Metropolitan Area Transit Authority L’Enfant Plaza Station Electrical Arcing and Smoke Accident, Washington, D.C., January 12, 2015 PY - 2016/05/03 SP - 166p AB - On January 12, 2015, at 3:15 p.m. eastern standard time, Washington Metropolitan Area Transit Authority (WMATA) southbound Yellow Line train 302, with about 380 passengers on board, stopped after encountering heavy smoke in the tunnel between the L’Enfant Plaza station and the Potomac River bridge in Washington, DC. The operator of train 302 told the Rail Operations Control Center (ROCC) that the train was filling with smoke and he needed to return to the station. The ROCC allowed train 510, following train 302, to enter the L’Enfant Plaza station, which also was filling with smoke. Train 302 was unable to return to the station before power to the electrified third rail, which supplied the train’s propulsion power, was lost. Some passengers on train 302 evacuated the train on their own, and others were assisted in evacuating by first responders from the District of Columbia Fire and Emergency Medical Services Department. As a result of the accident, 91 people were injured, including passengers, emergency responders, and WMATA employees, and one passenger died. WMATA estimated the total damages to be $120,000. The safety issues and conditions identified in this accident, which illustrate WMATA’s lack of a safety culture, are the WMATA response to smoke reports, tunnel ventilation, railcar ventilation, emergency response, and oversight and management of WMATA. The National Transportation Safety Board determines that the probable cause of the Washington Metropolitan Area Transit Authority L’Enfant Plaza station electrical arcing and smoke accident was a prolonged short circuit that consumed power system components resulting from the Washington Metropolitan Area Transit Authority’s (WMATA) ineffective inspection and maintenance practices. The ineffective practices persisted as the result of (1) the failure of WMATA senior management to proactively assess and mitigate foreseeable safety risks and (2) the inadequate safety oversight by the Tri-State Oversight Committee and the Federal Transit Administration. Contributing to the accident were WMATA’s failure to follow established procedures and the District of Columbia Fire and Emergency Medical Services Department’s being unprepared to respond to a mass casualty event on the WMATA underground system. As a result of the investigation of this accident, the National Transportation Safety Board makes safety recommendations to the Federal Transit Administration, the mayor of the District of Columbia, the District of Columbia Office of Unified Communications, the District of Columbia Fire and Emergency Medical Services Department, and the Washington Metropolitan Area Transit Authority. KW - Crash causes KW - Crash investigation KW - Electric arcs KW - Emergency response time KW - Oversight KW - Railroad crashes KW - Railroad safety KW - Railroad tunnels KW - Smoke KW - Ventilation systems KW - Washington (District of Columbia) KW - Washington Metropolitan Area Transit Authority UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1601.pdf UR - https://trid.trb.org/view/1410765 ER - TY - SER AN - 01600779 JO - Highway accident report PB - National Transportation Safety Board AU - National Transportation Safety Board TI - Highway Accident Brief: Bus Roadway Departure and Collision with Moving Train, Interstate 20, Ector County, near Penwell, Texas, January 14, 2015 PY - 2016/04/21 SP - 13p AB - On Wednesday, January 14, 2015, about 7:50 a.m. local time, a 2015 Blue Bird Vision prison bus was traveling westbound on Interstate 20 (I-20) near Penwell, Texas, when it departed the roadway and collided with a moving train. The bus, operated by the Texas Department of Criminal Justice (TDCJ), was occupied by 12 inmates and three correctional officers (including the driver). The trip began about 4:40 a.m. at the John Middleton Transfer Facility in Abilene. The bus was traveling in the left lane at an estimated speed of 57 mph. As the bus approached a two-lane bridge, it was positioned behind one truck-tractor semitrailer combination vehicle and alongside another combination vehicle. A section of W-beam guardrail, damaged in a previous crash, was partially intruding into the left lane. Although the driver applied the brakes momentarily, the bus struck this section of the guardrail and moved sharply to the left. The bus departed the left edge of the westbound roadway, overrode the previously damaged guardrail, entered the median, and became airborne between the westbound and eastbound parallel bridges. At the same time, a Union Pacific (UP) freight train was traveling southbound under the highway overpass. The bus fell about 20 feet onto an earthen area at the base of a concrete slope, on the east side of the railroad tracks, and continued forward, striking an intermodal flatcar. The train redirected the bus southward, and the left side of the bus collided with pillars supporting the eastbound bridge. The bus body and separated components came to rest along the east side of the tracks, about 220 feet south of the impact area. Although the train stopped, it did not derail. At the time of the crash, light mist precipitation was present with no snow accumulation. Icy road conditions on the eastbound approach had previously been reported, resulting in several single-vehicle crashes, including at least three median crossover crashes and damage to the guardrail. The prison bus crash resulted in 10 fatalities: two correctional officers (including the driver) and eight inmates. The remaining five bus occupants sustained serious injuries and were transported to Medical Center Hospital in Odessa. No members of the train crew were injured. The National Transportation Safety Board determines that the probable cause of the crash was the bus loss of control due to striking the portion of damaged guardrail intruding into the left travel lane of Interstate 20 westbound. Contributing to the crash was the displaced and damaged condition of the guardrail due to multiple previous impacts by other vehicles in separate crashes, attributed to icy road conditions in the eastbound lanes. KW - Bus crashes KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Guardrails KW - Penwell (Texas) KW - Railroad crashes KW - Ran off road crashes KW - Snow and ice control UR - http://ntsb.gov/investigations/AccidentReports/Reports/HAB-16-03.pdf UR - https://trid.trb.org/view/1409213 ER - TY - RPRT AN - 01596703 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Birmingham Public Housing Gas Explosion, Birmingham, Alabama, December 17, 2013 PY - 2016/03/30 SP - 14p AB - ​At 2:29 a.m. on December 17, 2013, one side (unit 80) of a two-story duplex at a public housing project in Birmingham, Alabama, exploded when natural gas in the apartment ignited. The explosion and fire destroyed unit 80 and heavily damaged the adjoining apartment (unit 79). The explosion also damaged several adjacent homes at the Charles P. Marks Village, operated by the Housing Authority of the Birmingham District. ​The National Transportation Safety Board determines that the probable cause of the accident was the release of natural gas through a large crack in the 62-year-old, cast iron gas main that resulted when tree growth cracked the corroded pipe. Once the accumulating gas reached the explosive limit inside the apartment, an active pilot light on an appliance ignited the gas. Contributing to the accident was the absence of the odorant, which was absorbed by the soil and prevented residents from smelling the gas. KW - Apartment buildings KW - Birmingham (Alabama) KW - Crash causes KW - Crash investigation KW - Explosions KW - Natural gas pipelines KW - Pipeline safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB1601.pdf UR - https://trid.trb.org/view/1403172 ER - TY - RPRT AN - 01599339 AU - National Transportation Safety Board TI - Safety Recommendation Report: Crash-Resistant Fuel Systems on Airbus Helicopters PY - 2016/03/23 SP - 4p AB - The National Transportation Safety Board (NTSB) is providing the following information to urge the Federal Aviation Administration (FAA) and the European Aviation Safety Agency (EASA) to take action on the safety recommendations in this report. These recommendations address the need for owners and operators of existing AS350 B3e helicopters and similarly designed variants to incorporate a crash-resistant fuel system into their rotorcraft. These recommendations are derived from two 2015 accidents in which the impact forces were survivable for occupants but fatal and serious injuries occurred because of post crash fires that resulted from an impact-related breach in the fuel tanks. As a result of these investigations, the NTSB is issuing three safety recommendations to the FAA and one safety recommendation to EASA. KW - Aviation safety KW - Crashworthiness KW - European Aviation Safety Agency KW - Fire KW - Fuel systems KW - Helicopters KW - Recommendations KW - U.S. Federal Aviation Administration UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/ASR-16-02.pdf UR - https://trid.trb.org/view/1405064 ER - TY - RPRT AN - 01603515 AU - National Transportation Safety Board TI - Safety Recommendation Report: Preventing Windshield Arcing, Smoke, and Fire on Bombardier DHC-8 Airplanes PY - 2016/03/11 SP - 6p AB - The National Transportation Safety Board (NTSB) is providing the following information to urge Bombardier, Inc., to take action on the safety recommendations in this letter. These recommendations are intended to prevent the recurrence of windshield arcing, smoke, fire, and overheating on Bombardier DHC-8 airplanes. They are derived from the NTSB’s investigation of a June 5, 2015, incident involving United Express flight 4776 (operated by CommutAir) as it approached Bradley International Airport, Windsor Locks, Connecticut. As a result of this investigation, the NTSB is issuing five safety recommendations to Bombardier, Inc. KW - Air transportation crashes KW - Aviation safety KW - Bombardier aircraft KW - Crash investigation KW - Electric arcs KW - Fire KW - Fire causes KW - Recommendations KW - Windshields UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/ASR-16-01.pdf UR - https://trid.trb.org/view/1410766 ER - TY - RPRT AN - 01594438 AU - National Transportation Safety Board TI - Railroad Accident Brief: CSXT Petroleum Crude Oil Train Derailment and Hazardous Materials Release, Lynchburg, Virginia, April 30, 2014 PY - 2016/03/02 SP - 13p AB - On April 30, 2014, at 1:54 p.m. eastern daylight time, 17 CSX Transportation (CSXT) tank cars on petroleum crude oil unit train K08227 derailed in Lynchburg, Virginia. Three of the derailed cars were partially submerged in the James River. One was breached and released about 29,868 gallons of crude oil into the river, some of which caught fire. No injuries to the public or crew were reported. At the time of the accident, it was cloudy and raining lightly; the temperature was 53° F. The CSXT estimated the damages at $1.2 million, not including environmental remediation. The National Transportation Safety Board determines that the probable cause of this accident was a broken rail caused by a reverse detail fracture with evidence of rolling contact fatigue. KW - Crash causes KW - Crash investigation KW - CSX Transportation KW - Derailments KW - Fires KW - Hazardous materials KW - Lynchburg (Virginia) KW - Oil spills KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1601.pdf UR - https://trid.trb.org/view/1400904 ER - TY - RPRT AN - 01603616 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision between Tanker Chembulk Houston and Container Ship Monte Alegre PY - 2016/02/23 SP - 10p AB - ​On March 5, 2015, at 1334, tanker Chembulk Houston and container ship Monte Alegre collided and grounded in the Houston Ship Channel, after the pilots agreed to let the Chembulk Houston overtake the Monte Alegre. Both ships were inbound in the channel. No injuries or pollution resulted from the accident, but both vessels sustained damage above their waterlines, totaling more than $1.7 million. The National Transportation Safety Board determines that the probable cause of the collision between the Chembulk Houston and the Monte Alegre was the pilot’s decision to increase speed on the Monte Alegre without informing the deputy pilot on the overtaking Chembulk Houston. KW - Containerships KW - Crash causes KW - Crash investigation KW - Galveston Bay KW - Groundings (Maritime crashes) KW - Houston Ship Channel KW - Tankers KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1604.pdf UR - https://trid.trb.org/view/1410767 ER - TY - RPRT AN - 01591963 AU - National Transportation Safety Board TI - Highway Accident Brief: 15-Passenger Van Roadway Departure, Moore Haven, Florida, March 30, 2015 PY - 2016/01/20 SP - 13p AB - About 12:30 a.m. eastern daylight time on March 30, 2015, a 2000 Dodge B3500 Ram 15-passenger van was traveling eastbound on State Road 78 (SR-78) West approaching the T-intersection with US Highway 27 (US-27) near Moore Haven, in Glades County, Florida. The 15-passenger van, which was operated by the Independent Haitian Assembly of God Church in Fort Pierce, Florida, and driven by a 58-year-old male, was transporting 16 adults and a 4-year-old child back to Fort Pierce following a revival celebration at the Eglise De Dieu La Jerusalem Celeste Church in Fort Myers, Florida. The van failed to stop at the stop sign at the T-intersection with US-27. The van traveled through the intersection, went off the roadway onto the grass shoulder on the north side of US-27, vaulted across a canal, and struck the far side bank, coming to rest 46 feet north of the intersection in the shallow canal, facing northeast. One of the survivors crawled out of the van, walked to the edge of the highway, and waved down help. The collision resulted in eight deaths; the remaining van occupants received injuries ranging from minor to serious and were transported to area hospitals for treatment. The National Transportation Safety Board determines that the probable cause of the Moore Haven, Florida, crash was the failure of the 15-passenger van driver to stop at a posted stop sign, possibly as a result of impairment from the use of a sedating antihistamine. Contributing to the severity of the injuries was the loading of more passengers into the van than it had seat belts, the nonuse of available seat belts, and the operation of the van with an unsecured fourth-row seat that had no passenger restraints. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Moore Haven (Florida) KW - Ran off road crashes KW - Seat belts KW - Traffic crashes KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1602.pdf UR - https://trid.trb.org/view/1398233 ER - TY - RPRT AN - 01591974 AU - National Transportation Safety Board TI - Marine Accident Brief: Engine Room Fire on Board Commercial Fishing Vessel Miss Eva, with Subsequent Sinking PY - 2016/01/14 SP - 9p AB - About 0708 local time on December 1, 2014, a fire broke out in the engine room of the commercial fishing vessel Miss Eva. The vessel's location was Gulf of Mexico, Ship Shoal Block 154, about 35 miles southwest of Grand Isle, Louisiana. The master and three crewmembers abandoned ship and were rescued by the offshore supply vessel Dustin Danos. Two US Coast Guard helicopters transported the crewmembers ashore for medical treatment. The vessel and the 35,000 pounds of shrimp it was transporting were considered a total loss. At the time of the accident, the Miss Eva had an estimated 3,200 gallons of marine diesel fuel and 100 gallons of hydraulic oil on board. No sheen was reported. The National Transportation Safety Board determines that the probable cause of the accident involving the commercial fishing vessel Miss Eva was an engine room fire that began from an undetermined source followed by downflooding and the eventual sinking of the vessel. KW - Crash causes KW - Crash investigation KW - Fire KW - Fishing vessels KW - Gulf of Mexico KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1601.pdf UR - https://trid.trb.org/view/1398234 ER - TY - RPRT AN - 01588155 AU - National Transportation Safety Board TI - Highway Accident Brief: Motorcoach Run-off-Road and Overturn, State Route 1 ramp to US Route 13 north, Red Lion, New Castle County, Delaware, September 21, 2014 PY - 2016/01/11 SP - 12p AB - On Sunday, September 21, 2014, about 4:15 p.m. local time, a 1996 Setra motorcoach was traveling on State Route 1 (SR-1) in Delaware en route to New York City. The motorcoach was returning from a 2-day tour that originated in New York City, with planned sightseeing stops in New York State, New Jersey, Pennsylvania, Maryland, and Washington, DC. The driver reported being familiar with the planned route. However, while traveling northbound on Interstate 95, he encountered traffic congestion and decided to divert. He took US Route 40 (US-40, Pulaski Highway) northeast to SR-1 south and then entered the curved access ramp to US Route 13 (US-13) north. The driver was unfamiliar with this alternate route and reported using his personal global positioning system (GPS) to navigate. At the point where the SR-1 access ramp curves sharply to the right, the driver failed to negotiate the curve, and the motorcoach departed the left edge of the roadway. The motorcoach entered an earthen area, rotated clockwise, and overturned onto its left (driver) side and partially onto its roof, coming to rest about 25 feet off the roadway. The motorcoach occupants included the 56-year-old driver and 50 passengers. The motorcoach was operated by AM USA Express. Three passengers died as a result of the crash, and the driver and 47 passengers were injured. At the time of the crash, the weather was clear, and the road conditions were dry. The National Transportation Safety Board (NTSB) completed a field investigation of this crash, focusing on highway, vehicle, human performance, and motor carrier factors. The National Transportation Safety Board determines that the probable cause of the September 21, 2014, motorcoach crash near Red Lion, Delaware, was the excessive speed at which the driver negotiated the decreasing radius of the single-lane access ramp from State Route 1 to US Route 13 north, resulting in a loss of control of the motorcoach. Contributing to the crash were the decreasing radius curve and the lack of traffic signage warning of the curve. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Delaware KW - Fatalities KW - Highway curves KW - Highway safety KW - Ramps (Interchanges) KW - Ran off road crashes KW - Rollover crashes KW - Speeding UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1601.pdf UR - https://trid.trb.org/view/1395630 ER - TY - RPRT AN - 01588171 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Bulk Carrier Flag Gangos with Oil Tanker Pamisos and Floating Pier PY - 2015/12/22 SP - 10p AB - At 2215 local time on August 12, 2014, the outbound bulk carrier Flag Gangos collided with the berthed oil tanker Pamisos on the Mississippi River at Gretna, Louisiana. The Flag Gangos subsequently allided with a pier at the facility where the Pamisos was berthed, and the pier struck and damaged a fuel barge, WEB235, berthed behind the Pamisos. No one was injured, but about 1,200 gallons of oil that was being transferred at the time spilled from the transfer lines, and some of the oil entered the river. Damage amounts were reported as $16 million for the terminal, more than $500,000 each for the Flag Gangos and the Pamisos, and about $418,000 for the fuel barge. The National Transportation Safety Board determines that the probable cause of the accident was the delay by the Flag Gangos’ operating company in completing a mandatory upgrade to the vessel’s steering system, and failure to routinely test the steering system’s hydraulic fluid for debris as required by the manufacturer. Contributing was the failure of the steering system manufacturer to schedule and complete the mandatory upgrade. KW - Allisions KW - Bulk carriers KW - Crash causes KW - Crash investigation KW - Gretna (Louisiana) KW - Oil spills KW - Oil tankers KW - Piers (Wharves) KW - Steering systems KW - Vehicle maintenance KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1525.pdf UR - https://trid.trb.org/view/1395631 ER - TY - RPRT AN - 01587734 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding and Sinking of Commercial Fishing Vessel Titan PY - 2015/12/21 SP - 8p AB - About 0215 Pacific standard time on December 5, 2014, the commercial fishing vessel Titan was proceeding outbound on the Columbia River when it grounded at the southern end of Jetty A off Cape Disappointment, Ilwaco, Washington. The vessel sustained hull damage and began to flood. Efforts to dewater the Titan were unsuccessful, and the five crew members abandoned the vessel after a US Coast Guard motor lifeboat arrived on scene. The Titan remained partially afloat by the stern and sank the next day. None of the Titan’s five crewmembers were injured. The Titan and its catch, an estimated 40,000 pounds of Dungeness crab, were declared a total loss. The vessel had an estimated 3,500 gallons of diesel oil, 700 gallons of hydraulic oil, and 400 gallons of lube oil on board. Oil sheens were sighted after the vessel sank. The vessel was not salvaged or recovered. ​The National Transportation Safety Board determines that the probable cause of the grounding and subsequent sinking of the Titan was the failure of the captain to monitor the vessel’s track as a result of falling asleep due to an accumulated sleep deficit after 4 days of continuous operations and the vessel owners’ lack of measures to mitigate crewmember fatigue. Contributing to the accident was the nature of the derby-style Dungeness fishery in the states of Washington and Oregon, which results in continuous fishing operations at the beginning of the season. KW - Crash causes KW - Crash investigation KW - Fatigue (Physiological condition) KW - Fishing vessels KW - Groundings (Maritime crashes) KW - Ilwaco (Washington) KW - Maritime safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1526.pdf UR - https://trid.trb.org/view/1395632 ER - TY - RPRT AN - 01583611 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Union Pacific Railroad Freight Trains, Galva, Kansas, September 25, 2014 PY - 2015/12/09 SP - 8p AB - On September 25, 2014, at about 5:44 a.m., eastbound Union Pacific Railroad (UP) train ILXG4X-22, collided with the side of westbound UP train KG4GSX-23 near Galva, Kansas. The westbound train was entering a siding, but it had not cleared the main track when it was struck by the eastbound train. Five multi-platform intermodal cars derailed from the westbound train. Two locomotive units and four multi-platform intermodal cars derailed from the eastbound train. The UP estimated about 200 gallons of diesel fuel leaked from the fuel tank of one of the derailed locomotives. No crewmembers on either train were seriously injured. No fire resulted from the collision. The National Transportation Safety Board determines that the probable cause of this accident was the green LED signal at CP 207 masking the red signal aspect at the east end of the Galva siding at CP 208, resulting in the crew of eastbound train ILXG4X-22 passing the red stop signal and colliding with westbound train KG4GSX-23. Contributing to the accident was the Union Pacific Railroad’s failure to conduct a risk assessment of the new control point installation at CP 207. KW - Crash causes KW - Crash investigation KW - Crashes KW - Freight trains KW - Galva (Kansas) KW - Light emitting diodes KW - Railroad crashes KW - Railroad safety KW - Railroad signals KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1508.pdf UR - https://trid.trb.org/view/1377581 ER - TY - RPRT AN - 01583555 AU - National Transportation Safety Board TI - Highway Accident Report: Truck-Tractor Semitrailer Median Crossover Collision With Medium-Size Bus on Interstate 35, Davis, Oklahoma, September 26, 2014 PY - 2015/11/17 SP - 82p AB - On September 26, 2014, about 9:05 p.m., a 2013 Peterbilt truck-tractor in combination with a 2014 Great Dane semitrailer, operated by Quickway Transportation Inc., was traveling north in the left lane of Interstate 35 (I-35), near Davis, Oklahoma. About the same time, a 2008 Champion Defender 32-passenger medium-size bus—transporting 15 members of the North Central Texas College (NCTC) softball team—was traveling south in the right lane of I-35. The college owned and operated the bus. In the vicinity of milepost 47, after negotiating a slight rightward curve at a speed of about 72 mph, the truck-tractor departed the left lane and entered the 100-foot-wide depressed earthen median at an approximate 2 degree angle. The truck-tractor continued through the median, traveling over 1,100 feet without evidence of braking or steering. The combination vehicle then entered the southbound lanes of I-35 at an approximate 9 degree angle and collided with the bus. Following the impact, the bus rolled onto its right side, and the truck-tractor continued off the roadway into a wooded area. As a result of the crash, four passengers on the bus were fully or partially ejected and died, and both drivers and the remaining passengers were injured. The National Transportation Safety Board determines that the probable cause of the Davis, Oklahoma, crash was the failure of the truck-tractor driver to control his vehicle due to incapacitation likely stemming from his use of synthetic cannabinoids. Contributing to the severity of injuries were the lack of restraint use by the bus passengers and the lack of appropriate crashworthiness standards for medium-size buses. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Crashworthiness KW - Davis (Oklahoma) KW - Drugged drivers KW - Fatalities KW - Restraint systems KW - Truck crashes KW - Truck tractors UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1503.pdf UR - https://trid.trb.org/view/1377585 ER - TY - RPRT AN - 01583629 AU - National Transportation Safety Board TI - Marine Accident Brief: Engine Room Fire on Board Towing Vessel Dennis Hendrix PY - 2015/11/09 SP - 9p AB - On October 31, 2014, about 0742 local time, the uninspected towing vessel Dennis Hendrix was transiting upbound on the lower Mississippi River while pushing 24 loaded barges when a fire broke out in the engine room. Crewmembers began to fight the fire, and other vessels in the area provided firefighting and towing assistance. The fire burned until mid-afternoon. None of the 10 crewmembers were injured and no environmental damage was reported. The damage to the Dennis Hendrix was estimated at $3.8 million. ​The National Transportation Safety Board determines that the probable cause of the engine room fire on board the Dennis Hendrix was a catastrophic failure of the starboard main engine resulting from loose bolts on the no. 5 cylinder rod cap while the engine was operating at a high load condition. KW - Crash causes KW - Crash investigation KW - Fire causes KW - Fires KW - Marine safety KW - Mississippi River KW - Towboats KW - Water transportation crashes UR - http://ntsb.gov/investigations/AccidentReports/Pages/MAB1522.aspx UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1522.pdf UR - https://trid.trb.org/view/1377582 ER - TY - RPRT AN - 01583498 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding of Commercial Fishing Vessel Savannah Ray PY - 2015/11/05 SP - 6p AB - About 0048 Alaska Standard Time on February 16, 2015, the commercial fishing vessel Savannah Ray grounded on the lee shore of Long Island, Alaska, while traveling in rough seas from fishing grounds off Ugak Island in the Gulf of Alaska to the vessel's home port at St. Paul Harbor, Kodiak Island, Alaska. The vessel then washed up on the beach about 5 miles from St. Paul Harbor. The four crewmembers were rescued from the vessel by a helicopter from US Coast Guard Air Station Kodiak. The insured value of the Savannah Ray was $800,000, and the vessel was deemed a constructive total loss as a result of the grounding. ​The National Transportation Safety Board determines that the probable cause of the grounding of the Savannah Ray was the vessel straying off course and entering shallow water because the captain fell asleep while navigating due to fatigue. Contributing to the grounding was the captain’s failure to use all of the vessel’s available alerting and navigation alarms. KW - Crash causes KW - Crash investigation KW - Fatigue (Physiological condition) KW - Fishing vessels KW - Groundings (Maritime crashes) KW - Long Island (Alaska) KW - Marine safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1524.pdf UR - https://trid.trb.org/view/1377583 ER - TY - RPRT AN - 01583558 AU - National Transportation Safety Board TI - Railroad Accident Brief: Locomotive Engineer Has Seizure While Operating Train, Arden, Nevada, August 7, 2014 PY - 2015/10/28 SP - 13p AB - On August 7, 2014, about 03:10 a.m. Pacific daylight time, Union Pacific Railroad (UP) local train LUM41-06 traveled into a Ken’s Foods, Inc. warehouse, ran through the end-of-track bumping post, and then collided with the inside wall while switching cars. The train consisted of 3 locomotives and 14 loaded tank cars. Three Ken’s Foods employees were in the warehouse at the time. Estimated damages were $188,000 and there were no injuries. ​The National Transportation Safety Board determines that the probable cause of the accident was the engineer’s failure to stop train LUM41-06 before it collided with the bumping post and the inside wall of the building because he was incapacitated by a seizure. Contributing to the accident was the Federal Railroad Administration’s failure to establish medical certification standards, other than hearing and vision criteria, for railroad employees in safety-sensitive positions. KW - Arden (Nevada) KW - Crash causes KW - Crash investigation KW - Locomotive engineers KW - Medical examinations and tests KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1507.pdf UR - https://trid.trb.org/view/1377586 ER - TY - RPRT AN - 01583568 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding and Subsequent Breakup of Dive Vessel King Neptune PY - 2015/10/27 SP - 9p AB - On the evening of December 30, 2014, in severe weather conditions, the 62-foot-long dive vessel King Neptune broke loose from its moorings in Avalon Harbor, Catalina Island, California. At the time, no one was on board. A harbor patrol officer, who later jumped on board the vessel to try to move it to a safe mooring location, died after falling into the water and becoming pinned between the vessel and a seawall. Under continuous wave action, the King Neptune broke apart and subsequently sank. ​The National Transportation Safety Board determines that the probable cause of the breakup and subsequent sinking of the King Neptune was the failure of the vessel’s mooring equipment in severe weather conditions and the Avalon Harbor Department’s inability to prevent the vessel from drifting ashore. Contributing to the death of the patrol officer who jumped on board was the Avalon Harbor Department’s decision to allow personnel to board a drifting vessel in severe weather conditions without a plan for communication and retrieval. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Groundings (Maritime crashes) KW - Marine safety KW - Santa Catalina Island (California) KW - Securing and joining equipment KW - Ships UR - http://ntsb.gov/investigations/AccidentReports/Pages/MAB1523.aspx UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1523.pdf UR - https://trid.trb.org/view/1377587 ER - TY - RPRT AN - 01581078 AU - National Transportation Safety Board TI - Special Investigation Report: Selected Issues in Passenger Vehicle Tire Safety PY - 2015/10/27 SP - 75p AB - Each year, about 33,000 tire-related passenger vehicle crashes occur, resulting in about 19,000 injuries. In 2013, a total of 539 people died in tire-related passenger vehicle crashes. This special investigation report summarizes the National Transportation Safety Board (NTSB) investigations into four such crashes and discusses the safety issues uncovered. This report also considers statements made by experts during the December 9 and 10, 2014, Passenger Vehicle Tire Safety Symposium held by the NTSB in Washington, DC. Among the issues this report addresses are problems with the tire registration and safety recall system, failure to establish the current level of crash risk posed by tire aging and the lack of consumer guidance on this issue, poor tire maintenance practices by consumers, and barriers to technological innovation that could prevent or mitigate tire-related crashes. Safety recommendations to the National Highway Traffic Safety Administration, AAA, the Rubber Manufacturers Association, and the major tire manufacturers are included. KW - Aging (Materials) KW - Crash causes KW - Crash investigation KW - Passenger vehicles KW - Recall campaigns KW - Recommendations KW - Registration KW - Service life KW - Technological innovations KW - Tires KW - Traffic crashes KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-studies/Documents/SIR1502.pdf UR - https://trid.trb.org/view/1375532 ER - TY - SER AN - 01580931 JO - Highway accident report PB - National Transportation Safety Board AU - National Transportation Safety Board TI - Highway Accident Brief: 15-passenger Van Roadway Departure and Overturn, Interstate 75, just north of US Route 90, Lake City, Florida, February 21, 2014 PY - 2015/10/27 SP - 11p AB - About 8:15 a.m. eastern standard time on February 21, 2014, a 2002 Ford E-350 XLT Super Duty 15-passenger van was traveling northbound on Interstate 75 (I-75) near Lake City, Columbia County, Florida. The van—operated by the First Baptist Church of New Port Richey, Floridawas transporting three adults and seven children, ranging in age from 11 to 16 years old, to a church camp in Covington, Georgia. During the trip, the driver of the van became concerned by a vibration he perceived to be coming from one of the vehicle’s tires, and he pulled off the highway into a rest area to investigate. Finding nothing visibly wrong, he continued on the trip. After traveling an additional 13 miles on I-75, the driver lost control of the vehicle when the left rear tire experienced a complete tire tread separation near US Route 90. The tire carcass remained inflated following the tread separation. The van moved to the right as it rotated counter-clockwise; departed the roadway onto a grassy, sloped embankment; and rolled 270 degrees about its longitudinal axis. During the rollover, the driver, one adult passenger, and two children were ejected from the vehicle. The two ejected adults died as a result of the crash. The remaining van occupants received various injuries and were transported to area hospitals for treatment. Following the crash, it was determined that the left rear tire had been subject to a manufacturer-initiated recall. The National Transportation Safety Board determines that the probable cause of the Lake City, Florida, crash was the failure of the left rear tire due to a tread separation, which led to the loss of vehicle control. Contributing to the crash were the failure of the tire merchant to adhere to its training material and provide the purchaser with a tire registration form as required, and record-keeping discrepancies that inadvertently allowed an outdated address to be used in the recall notification process. Contributing to the severity of the injuries was the nonuse of available seat belts. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Lake City (Florida) KW - Recall campaigns KW - Seat belts KW - Tire treads KW - Traffic crashes KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1502.pdf UR - https://trid.trb.org/view/1375100 ER - TY - RPRT AN - 01580895 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Fishing Vessel Blazer PY - 2015/10/06 SP - 6p AB - On November 29, 2014, at 0611 local time, the 73-foot-long fishing vessel Blazer, loaded with Dungeness crab pots, sank in the Pacific Ocean about 8 miles west of Siletz Bay, Oregon. All five crewmembers abandoned ship and were rescued by the US Coast Guard. The Blazer, valued at $950,000, sank with 2,000 gallons of diesel fuel and mixed lube oil products on board. No pollution was sighted. The National Transportation Safety Board determines that the probable cause of the sinking of the Blazer was flooding from an unknown point of ingress. KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Oregon KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1521.pdf UR - https://trid.trb.org/view/1375101 ER - TY - RPRT AN - 01579263 AU - National Transportation Safety Board TI - Marine Accident Brief: Partial Sinking of Small Passenger Vessel Spirit of Adventure PY - 2015/09/30 SP - 8p AB - The Spirit of Adventure, a 99-gross ton catamaran small passenger vessel, flooded and partially sank while alongside its pier in Seward Boat Harbor, Alaska, before dawn on December 6, 2014. The vessel was out of service for the winter, and no one was on board. No injuries or pollution occurred as a result of the sinking. Damage to the vessel and its pier was estimated at $2 million, and the vessel was declared a constructive total loss by its insurer. The Spirit of Adventure was one of eight vessels operated by Major Marine Tours on sightseeing tours from Seward to Kenai Fjords National Park and Prince William Sound, Alaska. The National Transportation Safety Board determines that the probable cause of the partial sinking of the Spirit of Adventure was the failure to ensure watertight integrity during the vessel’s winter maintenance period, which resulted from the operator’s lack of a formal safety system, including a lock-out/tag-out policy and a vessel winterization procedure. KW - Catamarans KW - Crash analysis KW - Crash investigation KW - Passenger ships KW - Seward (Alaska) KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1520.pdf UR - https://trid.trb.org/view/1371566 ER - TY - RPRT AN - 01580966 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Crane Barge, Pushed by Towing Vessel Cory Michael, with the Florida Avenue Bridge, New Orleans, Louisiana, August 13, 2014 PY - 2015/09/22 SP - 30p AB - About 2355 on August 13, 2014, a crane barge transported by the towing vessel Cory Michael struck the raised lift span of the Florida Avenue Bridge while transiting on the Industrial Canal in New Orleans, Louisiana. The crane boom fell onto the towing vessel’s upper wheelhouse, fatally injuring the captain. Damage to the crane and the vessel totaled $2.3 million. The National Transportation Safety Board determines that the probable cause of the allision of the Cory Michael tow with the Florida Avenue Bridge was the captain’s failure to establish the correct air draft of his tow and ensure that the bridge was raised to an adequate height before attempting the passage, and the failure of the bridge operator for the Port of New Orleans to raise the lift span to the fullest extent as required by regulations and port policy. Safety issues identified in this investigation include: (1) Inadequate oversight of bridge and towing vessel operations: Investigators learned that the US Coast Guard’s Bridge Administration did not know that the lift span of the Florida Avenue Bridge was not being raised to its fullest extent for vessel passage since Hurricane Katrina damaged the bridge in 2005. (2) Inadequate and complacent safety management practices: Although the operating company of the towing vessel had a safety policy in place, it was not being successfully implemented on board. Further, the crane boom was transported in an unsupported and dangerous manner, and the correct air draft of the tow was not established before the attempted transit under the Florida Avenue Bridge. As a result of this investigation, the National Transportation Safety Board makes new recommendations to the US Coast Guard, the Port of New Orleans, Boh Bros. Construction, and the Occupational Safety and Health Administration. KW - Allisions KW - Barges KW - Crash causes KW - Crash investigation KW - Fatalities KW - Florida Avenue Bridge (New Orleans, Louisiana) KW - Marine safety KW - Towboats UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1502.pdf UR - https://trid.trb.org/view/1375102 ER - TY - RPRT AN - 01577539 AU - National Transportation Safety Board TI - Aircraft Accident Report: Runway Overrun During Rejected Takeoff, Gulfstream Aerospace Corporation G-IV, N121JM, Bedford, Massachusetts, May 31, 2014 PY - 2015/09/09 SP - 83p AB - This report discusses the May 31, 2014, accident in which a Gulfstream Aerospace Corporation G-IV, N121JM, registered to SK Travel, LLC, and operated by Arizin Ventures, LLC, crashed after it overran the end of runway 11 during a rejected takeoff at Laurence G. Hanscom Field, Bedford, Massachusetts. The two pilots, a flight attendant, and four passengers died. The airplane was destroyed by impact forces and a postcrash fire. The National Transportation Safety Board (NTSB) determines that the probable cause of this accident was the flight crewmembers’ failure to perform the flight control check before takeoff, their attempt to take off with the gust lock system engaged, and their delayed execution of a rejected takeoff after they became aware that the controls were locked. Contributing to the accident were the flight crew’s habitual noncompliance with checklists, Gulfstream Aerospace Corporation’s failure to ensure that the G-IV gust lock/throttle lever interlock system would prevent an attempted takeoff with the gust lock engaged, and the Federal Aviation Administration’s failure to detect this inadequacy during the G-IV’s certification. Safety recommendations are addressed to the Federal Aviation Administration, the International Business Aviation Council, and the National Business Aviation Association. KW - Air transportation crashes KW - Aviation safety KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Fatalities KW - Laurence G Hanscom Field Airport KW - Runway overruns KW - Takeoff UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1503.pdf UR - https://trid.trb.org/view/1370711 ER - TY - RPRT AN - 01583635 AU - National Transportation Safety Board TI - Marine Accident Brief: Engine Room Fire on Board Recreational Vessel La Pietra, with Subsequent Sinking PY - 2015/09/01 SP - 5p AB - On July 4, 2014, at 1058 local time, a fire broke out in the engine room on board the 79-foot-long recreational vessel La Pietra, when the vessel was near Destruction Island, Washington. The onboard vessel owners (husband and wife) were rescued by the US Coast Guard; the husband was treated for smoke inhalation and minor burns. La Pietra burned to the waterline and sank with 600 gallons of diesel fuel onboard. ​The National Transportation Safety Board determines that the probable cause of the La Pietra accident was an engine room fire of unknown origin. Contributing to the loss of the vessel was the owners’ inability to access and shut off the engine room ventilation system, which diminished the effectiveness of the fire suppression system and extinguishing efforts. KW - Crash investigation KW - Fire causes KW - Fires KW - Marine safety KW - Ships KW - Washington (State) KW - Water transportation crashes UR - http://ntsb.gov/investigations/AccidentReports/Pages/MAB1519.aspx UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1519.pdf UR - https://trid.trb.org/view/1377589 ER - TY - RPRT AN - 01576227 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Towing Vessel Nalani PY - 2015/08/19 SP - 10p AB - About 1510 local time on January 22, 2015, the uninspected towing vessel Nalani began taking on water and sank in 2,200 feet of water while conducting sea trials off the southwest coast of Oahu, Hawaii. All 11 persons on board were rescued after abandoning the vessel. No one was injured. An oil sheen was observed by responders and crewmembers. The vessel was not salvaged due to the water depth and was declared a total constructive loss. ​The National Transportation Safety Board determines that the probable cause of the flooding and eventual sinking of the Nalani was the captain’s decision to get under way without sufficient freeboard at the stern and without ensuring proper watertight integrity. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Oahu (Hawaii) KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1517.pdf UR - https://trid.trb.org/view/1367431 ER - TY - RPRT AN - 01576188 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Offshore Supply Vessel Gloria May and Fishing Vessel Capt Le PY - 2015/08/10 SP - 7p AB - The offshore supply vessel Gloria May collided with the uninspected fishing vessel Capt Le in the Gulf of Mexico about 2040 on the evening of August 24, 2014. As a result of the collision, the hull of the Capt Le was breached and the vessel flooded and sank; the bow of the Gloria May suffered minor damage. Three crewmembers from the Capt Le abandoned their sinking vessel into a liferaft and were recovered by the crew of the Gloria May. No injuries resulted from the accident. Total damage was estimated at $225,000. The National Transportation Safety Board determines that the probable cause of the collision between the offshore supply vessel Gloria May and the fishing vessel Capt Le was the failure of both vessels’ operators to maintain a proper lookout. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fishing vessels KW - Gulf of Mexico KW - Supply vessels KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1516.pdf UR - https://trid.trb.org/view/1367432 ER - TY - RPRT AN - 01576137 AU - National Transportation Safety Board TI - Railroad Accident Brief: National Passenger Rail Corporation Maintenance-of-Way Employee Fatality, Clermont, New York, October 29, 2014 PY - 2015/08/07 SP - 8p AB - On October 29, 2014, at 10:56 a.m. eastern daylight time, National Railroad Passenger Corporation (Amtrak) train A280 struck and killed an Amtrak signal helper. Earlier that morning, the Amtrak employee had provided protection for a contractor who was installing cable earlier near milepost 100.9 in Clermont, New York. At the time of the accident, the sky was overcast with occasional rain; the temperature was 58° F. There were 128 passengers on board the train. An engineer and an engineer who was qualifying for a new territory were in the locomotive cab; a conductor and an assistant conductor were in the passenger cars. No one on the train was injured. The National Transportation Safety Board determines the probable cause of the accident was that the signal helper was occupying main track 1 without securing on-track protection. KW - Amtrak KW - Clermont (New York) KW - Crash causes KW - Crash investigation KW - Employees KW - Fatalities KW - Maintenance of way KW - Occupational safety KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1506.pdf UR - https://trid.trb.org/view/1367433 ER - TY - RPRT AN - 01576223 AU - Renze, Kevin J AU - National Transportation Safety Board TI - Train Braking Simulation Study PY - 2015/07/20 SP - 32p AB - A generic train stopping distance simulation study was performed to quantify the expected tank car unit train stopping distance as a function of train mass, train speed, track grade, train braking configuration (conventional pneumatic (CONV) 10% Net Braking Ratio (NBR), distributed power pneumatic (DP) 10% NBR, electronically controlled pneumatic (ECP) 10% NBR, ECP 12.8% NBR, and ECP 14% NBR), type of brake application (emergency or full service), and locomotive brake use. Locomotive brakes were modeled bailed off or applied, as applicable, for both emergency and full service brake application scenarios for all train braking configurations. Benefits from the use of advanced train braking systems come from three sources: reduced stopping distances (fewer cars in a potential pileup), reduced vehicle kinetic energy (less energy available to puncture cars in a pileup), and lower and more uniform in-train coupler forces (more compatible car-to-car interaction). This study documents the calculated stopping performance capability of CONV, DP, and ECP train braking systems for a nominal car NBR of 10% (to compare different brake signal propagation rate effects). In addition, the stopping distance benefit due to increasing NBR for exemplar CONV, DP, and ECP trains is illustrated. Finally, this study evaluates the combined brake signal propagation rate and increased brake shoe force benefits of increasing the NBR for an ECP train relative to a CONV train. KW - Brakes KW - Braking KW - Braking performance KW - Positive train control KW - Railroad crashes KW - Railroad trains KW - Simulation KW - Stopping distances UR - http://dms.ntsb.gov/public/55500-55999/55926/577439.pdf UR - https://trid.trb.org/view/1367527 ER - TY - RPRT AN - 01570381 AU - National Transportation Safety Board TI - Railroad Accident Brief: Employee Switching Fatality, Colorado Springs, Colorado, October 8, 2014 , PY - 2015/07/14 SP - 8p AB - ​On October 8, 2014, at 12:30 p.m. mountain daylight time, a BNSF Railway (BNSF) conductor died while BNSF local train L-PWR0223-8 I was pulling nine railroad cars on an industry track on the Pikes Peak Subdivision near Colorado Springs, Colorado. The National Transportation Safety Board determines that the probable cause of the accident was the conductor leaving cars on track 813 with insufficient clearance to the adjacent track and then instructing the engineer to move the railroad cars on track 816 before stepping clear of the moving cars. The conductor’s focus on successfully coupling the railroad cars on track 816 likely contributed to the accident. KW - BNSF Railway KW - Colorado Springs (Colorado) KW - Conductors (Trains) KW - Crash causes KW - Crash investigation KW - Fatalities KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1505.pdf UR - https://trid.trb.org/view/1361075 ER - TY - RPRT AN - 01570334 AU - National Transportation Safety Board TI - Highway Accident Brief: Tire Deflation and Tread Separation, Cross-median Crash, US Route 90 near Milepost 160.2, near Centerville, St. Mary Parish, Louisiana, February 15, 2014 PY - 2015/07/09 SP - 11p AB - On Saturday, February 15, 2014, about 11:30 a.m. local time, a 2004 Kia Sorento sport utility vehicle (SUV), occupied by a 37-year-old driver and four passengers, was traveling westbound on US Route 90 (US-90) near Centerville, Louisiana. The SUV was traveling in the right lane at a witness-estimated speed of 70 mph (roadway speed limit) when the driver lost control of the vehicle due to a tread separation and rapid air loss in the left rear tire. The SUV veered into the left westbound lane, rotating in a counterclockwise direction, and departed the roadway into a 64-foot-wide depressed earthen median. It continued through the median, now rotating in a clockwise direction; entered the eastbound traffic lanes of US-90; and collided with a 2005 IC Bus (66-passenger school bus), which was traveling in the right lane. As a result of the crash, the Kia driver and the three rear seat passengers died. The fourth SUV passenger was seriously injured. Of the 35 school bus occupants, one student received serious injuries, 29 passengers and the bus driver sustained minor injuries, and four passengers were uninjured. The bus driver was wearing a seat belt, but the bus was not equipped with passenger seat belts. At the time of the crash, the weather was clear and the road conditions were dry. The National Transportation Safety Board determines that the probable cause of the Centerville, Louisiana, crash was the Kia SUV driver’s loss of control due to the tread separation and rapid air loss of the left rear tire, which altered vehicle handling characteristics. Contributing to the crash was the deteriorated condition of the tire due to inadequate maintenance. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Louisiana KW - Tire pressure KW - Tire treads KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1501.pdf UR - https://trid.trb.org/view/1360772 ER - TY - RPRT AN - 01567280 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Tank Barge Nash, Towed by Towing Vessel Calvin PY - 2015/06/16 SP - 8p AB - The tank barges Nash and Kenny were fully loaded with liquid magnesium chloride and being towed by the uninspected towing vessel Calvin from Guerrero Negro, Mexico, to British Columbia, Canada, when the Nash began to list noticeably to its starboard side about 1145 on June 8, 2014. Listing and trimming by the stern increased over the next 6 hours, and the US Coast Guard directed the Calvin captain to tow the Nash to a nearby anchorage. About 1805, the Nash sank stern first in 240 feet of water, about 3 nautical miles west of Point Conception, California. About a week after the sinking, a salvage team partially refloated the Nash and towed it to its disposal location about 17 nautical miles from shore. The National Transportation Safety Board determines that the probable cause of the sinking of tank barge Nash was flooding of the aft starboard side void tank. The mechanism for entry of flooding water to this tank could not be determined because the barge was not salvaged and was not available for examination after it sank. KW - Crash causes KW - Crash investigation KW - Maritime safety KW - Tank barges KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1512.pdf UR - https://trid.trb.org/view/1358957 ER - TY - RPRT AN - 01567355 AU - National Transportation Safety Board TI - Marine Accident Brief: Breakwater Pier Collapse in Eastport, Maine PY - 2015/06/12 SP - 8p AB - A 200-foot section on the western side of the Eastport breakwater pier in Eastport, Maine, collapsed about 0200 local time on December 4, 2014, damaging several vessels that were moored alongside. No injuries and minor pollution were reported. ​The National Transportation Safety Board determines that the probable cause of the collapse of the Eastport Port Authority breakwater pier was the failure of the lateral restraint system due to the structure's long-term deterioration. KW - Breakwaters KW - Collapse KW - Crash investigation KW - Deterioration KW - Eastport (Maine) KW - Marine safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1511.pdf UR - https://trid.trb.org/view/1358956 ER - TY - RPRT AN - 01567487 AU - National Transportation Safety Board TI - Special Investigation Report: The Use of Forward Collision Avoidance Systems to Prevent and Mitigate Rear-End Crashes PY - 2015/05/19 SP - 63p AB - Over the past 3 years, the National Transportation Safety Board (NTSB) has investigated nine rear-end accidents involving passenger or commercial vehicles striking the rear of another vehicle—the result of which was 28 fatalities and 90 injured people. In 2012, rear-end crashes resulted in 1,705 fatalities and represented almost half of all two-vehicle crashes. This Special Investigation Report reviews the previous recommendations made by the NTSB pertaining to the reduction of rear-end crashes and examines recent collision avoidance technologies that would aid in their prevention. The report concludes that collision warning systems, particularly when paired with active braking, could significantly reduce the frequency and severity of rear-end crashes. The report issues six new recommendations—four to the National Highway Traffic Safety Administration (NHTSA) and two to vehicle manufacturers, both passenger and commercial. In addition, it reiterates two recommendations to NHTSA and reclassifies four recommendations previously issued to NHTSA. KW - Braking KW - Crash avoidance systems KW - Crash severity KW - Rear end crashes KW - Recommendations UR - http://www.ntsb.gov/safety/safety-studies/Documents/SIR1501.pdf UR - https://trid.trb.org/view/1357208 ER - TY - RPRT AN - 01563540 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Bulk Carrier Anna Smile with Louis Dreyfus Grain Elevator PY - 2015/04/30 SP - 11p AB - The 738-foot-long bulk carrier Anna Smile allided with the Louis Dreyfus Grain Elevator in Houston, Texas, at 0504 local time on July 14, 2014,while maneuvering during docking operations. Damage to the grain elevator and its foundation was estimated at $2.5 million. The Anna Smile suffered minor insets on the hull plating on its starboard quarter for a length of about 30 feet. No injuries or pollution were reported. ​The National Transportation Safety Board determines that the probable cause of the allision of the bulk carrier Anna Smile with the Louis Dreyfus Grain Elevator while docking was a lack of communication from the engineering staff to the vessel’s bridge team and pilots while the vessel was experiencing problems with the starting system of the main engine as well as the absence of specific procedures and training for emergency engine operations. KW - Allisions KW - Bulk carriers KW - Crash causes KW - Crash investigation KW - Docking KW - Grain elevators KW - Houston (Texas) KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1508.pdf UR - https://trid.trb.org/view/1353318 ER - TY - RPRT AN - 01560950 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Union Pacific Railroad Freight Train MSIDV 16 with Standing Railroad Cars in Hays, Kansas, July 16, 2013 PY - 2015/04/14 SP - 8p AB - On July 16, 2013, at about 1:20 a.m., central daylight time, westbound Union Pacific Railroad (UP) freight train MSIDV 16 unexpectedly encountered a hand-operated main track switch at MP 288 in the reverse position diverting the train from the main track onto two adjacent tracks at the Sharon Springs subdivision in Hays, Kansas. The switch was not equipped with technology to warn oncoming trains that it was in the reverse position. At the time of the accident, the train was traveling in nonsignaled track warrant territory at a timetable speed of 49 mph. The lead locomotive collided with standing cars on the spur track. Diesel fuel leaked from the ruptured locomotive fuel tanks, ignited, and burned. The three crew members were injured. Damage was estimated by the UP to be $1.4 million. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the brakeman of train LDG89 15 to return a main track switch to the normal position after the crew had secured the train on a siding track. Contributing to the accident was the inability of the crew of train MSIDV 16 to determine the position of the main track switch in nonsignaled territory. KW - Crash causes KW - Crash investigation KW - Crashes KW - Freight trains KW - Hays (Kansas) KW - Railroad crashes KW - Railroad safety KW - Switches (Railroads) KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1504.pdf UR - https://trid.trb.org/view/1350690 ER - TY - RPRT AN - 01560991 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Chicago Transit Authority Trains, Forest Park, Illinois, September 30, 2013 PY - 2015/04/13 SP - 8p AB - On Monday, September 30, 2013,at 7:42 a.m. central daylight time, a set of unoccupied Chicago Transit Authority (CTA) passenger cars collided with CTA passenger train 110 at the Harlem-Congress passenger station in Forest Park, Illinois. The unoccupied cars were moving about 24 miles per hour when they struck the stopped train. Thirty-three passengers and the train operator were taken to local hospitals and later released. CTA estimated the property damage to be $6.4 million. ​The National Transportation Safety Board determines that the probable cause of the accident was water in the control cables of two cars, which caused errant control signals to be sent to the cars’ power systems. Contributing to the accident was the Chicago Transit Authority’s practice of not securing unattended equipment. KW - Chicago Transit Authority KW - Crash causes KW - Crash investigation KW - Crashes KW - Forest Park (Illinois) KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1502.pdf UR - https://trid.trb.org/view/1350689 ER - TY - RPRT AN - 01560879 AU - National Transportation Safety Board TI - Railroad Accident Brief: Bay Area Rapid Transit Train 963 Struck Roadway Workers, Walnut Creek, California, October 19, 2013 PY - 2015/04/13 SP - 6p AB - On Saturday, October 19, 2013, at 1:44 p.m. Pacific daylight time, Bay Area Rapid Transit District (BART) train 963 struck and killed two engineering employees while they were working on BART’s main tracks near Walnut Creek, California. The train, which included four passenger cars, was travelling north on the Pittsburgh/Bay Point-SFO (San Francisco International Airport) Line between the Walnut Creek and Pleasant Hill stations. It was one of two trains being operated by BART managers because BART’s union employees were on strike. Both trains were transporting management employees, who were being trained as substitute operators and system maintenance workers. No paying passengers were being transported by either train. The National Transportation Safety Board determines that the probable cause of the accident was the Bay Area Rapid Transit District’s use of simple approval for granting roadway worker access to the track, which required the workers to provide their own protection. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Occupational safety KW - Railroad crashes KW - Railroad safety KW - San Francisco Bay Area Rapid Transit District KW - Walnut Creek (California) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1503.pdf UR - https://trid.trb.org/view/1350688 ER - TY - RPRT AN - 01560903 AU - National Transportation Safety Board TI - Railroad Accident Brief: Film Crew Trespassing on CSX Right-of-Way, Jesup, Georgia, February 20, 2014 PY - 2015/03/23 SP - 7p AB - On February 20, 2014, about 4:30 p.m. eastern standard time, a crew of at least 12 people was filming a movie scene on a railroad bridge near Jesup, Georgia, when northbound CSX Transportation (CSX) freight train Q12519 approached. As the train passed the film crew’s location on the bridge, it struck a prop—a metal-framed bed. Debris from the prop struck some crewmembers on the bridge walkway. One film crewmember was killed, and six others with injuries were transported to local hospitals. The accident occurred in the CSX Nahunta Subdivision at milepost A543.7 on the railroad bridge across the Altamaha River. At the time of the accident, the train was operating on a single main track, with 2 locomotives and 37 freight cars. The train was traveling about 56 mph, in a region of track having a maximum authorized speed of 70 mph. The sky was clear, and the temperature was 80°F. The National Transportation Safety Board determines that the probable cause of the accident was the film crew’s unauthorized entry onto the CSX Transportation right-of-way at the Altamaha River bridge with personnel and equipment, despite CSX Transportation’s repeated denial of permission to access the railroad property. Contributing to the accident was the adjacent property owner’s actions to facilitate the film crew’s access to the right-of-way and bridge. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Jesup (Georgia) KW - Railroad crashes KW - Railroad safety KW - Trespassers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1501.pdf UR - https://trid.trb.org/view/1347703 ER - TY - RPRT AN - 01563471 AU - National Transportation Safety Board TI - Safety Report: Commercial Vehicle Onboard Video Systems PY - 2015/03/03 SP - 45p AB - The National Transportation Safety Board (NTSB) has investigated many highway accidents where onboard video systems recorded critical crash-related information. This safety report discusses two recent crashes where continuous video systems were installed on commercial vehicles. In a 2012 school bus crash in Port St. Lucie, Florida, the video recording system captured all three phases of the crash, including precrash driver and passenger behaviors and vehicle motion; vehicle and occupant motion during the crash; and postcrash events, such as passenger evacuation, short-term injury outcomes, and emergency response. In a 2011 motorcoach crash in Kearney, Nebraska, the video recording system captured critical precrash information but had certain limitations that negated the potential benefits of crash and postcrash event data. This report summarizes the analysis of the onboard video systems from these two crashes in particular. Further, to advance biomechanical and pediatric trauma-based research, it presents the video analysis and subsequent extensive injury documentation from the Port St. Lucie investigation. The NTSB makes recommendations to the National Highway Traffic Safety Administration; to the American Bus Association, United Motorcoach Association, American Trucking Associations, American Public Transportation Association, National Association for Pupil Transportation, National Association of State Directors of Pupil Transportation Services, and National School Transportation Association; and to 15 manufacturers of onboard video systems. KW - Bus crashes KW - Crash analysis KW - Crash causes KW - Digital video KW - Injury severity KW - Kearney (Nebraska) KW - Port St. Lucie (Florida) KW - Recommendations KW - School buses KW - Video cameras UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR1501.pdf UR - https://trid.trb.org/view/1353319 ER - TY - RPRT AN - 01560946 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire On Board Fish Processing Vessel Juno PY - 2015/02/23 SP - 5p AB - In the early morning hours on Saturday, December 28, 2013, the 138-foot-long fish processing vessel Juno caught fire while moored at its pier in Westport, Washington. Shoreside firefighters extinguished the blaze, which caused extensive damage. The master received minor injuries, and no pollution was reported as a result of the fire. The National Transportation Safety Board determines the probable cause of the fire on the fish processing vessel Juno was a space heater that experienced an electrical fault (short circuit). Contributing to the extent of the fire’s damage was the improper stowage of flammable materials near the heater. Also contributing was the vessel’s lack of structural fire protection and use of combustible materials in interior finishes. KW - Crash investigation KW - Fire causes KW - Fires KW - Flammable materials KW - Marine safety KW - Ships KW - Water transportation crashes KW - Westport (Washington) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1505.pdf UR - https://trid.trb.org/view/1347704 ER - TY - RPRT AN - 01557017 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of the ITB Krystal Sea/Cordova Provider with US Coast Guard Cutter Sycamore PY - 2015/02/18 SP - 16p AB - The integrated tug and barge Krystal Sea/Cordova Provider with four crewmembers on board was maneuvering to dock at the Alaska Marine Lines pier in Cordova, Alaska, when the bow ramp of the barge struck the moored US Coast Guard cutter Sycamore at the adjacent pier at 0616 on Sunday, July 28, 2013. The Sycamore, with 11 crewmembers on board, suffered about $244,000 in damage. The Cordova Provider’s bow ramp sustained about $5,000 in damage. No injuries or pollution were reported. The National Transportation Safety Board determines that the probable cause of the allision of the integrated tug and barge Krystal Sea/Cordova Provider with the US Coast Guard cutter Sycamore was the loss of directional control of one of two azimuthing stern drive propulsion units during an unsuccessful attempt by the Krystal Sea’s new captain to transfer from autopilot to manual control while approaching the intended dock. Contributing to the accident was the lack of function-testing of manual steering and propulsion control after disengaging the autopilot at a distance from the dock sufficient to allow time for corrective action. KW - Allisions KW - Cordova (Alaska) KW - Crash causes KW - Crash investigation KW - Docking KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1504.pdf UR - https://trid.trb.org/view/1345512 ER - TY - RPRT AN - 01560890 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision between US Fishing Vessel American Dynasty and Canadian Naval Frigate Winnipeg PY - 2015/02/03 SP - 10p AB - On April 23, 2013, at 0817 local time, the US-flag commercial fishing vessel American Dynasty was approaching the graving dock at Esquimalt in British Columbia, Canada, when it lost electrical power and propulsion control. The vessel veered off course and collided with a Canadian Navy frigate, HMCS (Her Majesty’s Canadian Ship) Winnipeg FFH 338 (“Winnipeg”), moored nearby. Both vessels sustained extensive structural damage, and the naval pier required repairs. Six shipyard workers suffered minor injuries. The National Transportation Safety Board determines that the probable cause of the collision between the American Dynasty and the Winnipeg was the insufficient planning between the American Dynasty’s master and chief engineer regarding vessel arrival procedures and emergency maneuvering, and the poor crisis communications between the bridge and the engine room. Contributing to the accident was the status and condition of the American Dynasty’s emergency generator and emergency batteries, which were not prepared to supply power at a critical time. KW - British Columbia KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Frigates KW - Maneuvering KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1503.pdf UR - https://trid.trb.org/view/1347705 ER - TY - RPRT AN - 01554350 AU - National Transportation Safety Board TI - Safety Study: Integrity Management of Gas Transmission Pipelines in High Consequence Areas PY - 2015/01/27 SP - 103p AB - There are approximately 298,000 miles of onshore natural gas transmission pipelines in the United States. Although rare, failure of these pipelines poses a significant risk to the public, especially when pipelines traverse populated areas, known as high consequence areas (HCA). To ensure the physical integrity of their systems in HCAs, gas transmission pipeline operators have been required by the Pipeline and Hazardous Materials Safety Administration (PHMSA) to develop and implement integrity management programs since 2004. The NTSB undertook this study because of concerns about deficiencies in the operators’ integrity management programs and the oversight of these programs by PHMSA and state regulators—concerns that were also identified in three gas transmission pipeline accident investigations conducted by the NTSB in the last five years. These accidents resulted in 8 fatalities and over 50 injuries, and they also destroyed 41 homes. This study used both quantitative and qualitative approaches. Data analysis was combined with insights on industry practices and inspectors’ experiences obtained through interviews and discussions with pipeline operators, state and federal inspectors, industry associations, and other stakeholders. This study found that while the PHMSA’s gas integrity management requirements have kept the rate of corrosion failures and material failures of pipe or welds low, there is no evidence that the overall occurrence of gas transmission pipeline incidents in HCA pipelines has declined. This study identified areas where improvements can be made to further enhance the safety of gas transmission pipelines in HCAs. Areas identified for safety improvements include (1) expanding and improving PHMSA guidance to both operators and inspectors for the development, implementation, and inspection of operators’ integrity management programs; (2) expanding the use of in-line inspection, especially for intrastate pipelines; (3) eliminating the use of direct assessment as the sole integrity assessment method; (4) evaluating the effectiveness of the approved risk assessment approaches; (5) strengthening aspects of inspector training; (6) developing minimum professional qualification criteria for all personnel involved in integrity management programs; and (7) improving data collection and reporting, including geospatial data. KW - Data analysis KW - Data collection KW - Inspection KW - Inspectors KW - Natural gas pipelines KW - Pipeline safety KW - Risk management KW - Stakeholders KW - U.S. Pipeline and Hazardous Materials Safety Administration UR - http://www.ntsb.gov/safety/safety-studies/Documents/SS1501.pdf UR - https://trid.trb.org/view/1343903 ER - TY - RPRT AN - 01554156 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Towing Vessel Bayou Lady With Bayou Blue Bridge PY - 2014/12/29 SP - 6p AB - The uninspected towing vessel (UTV) Bayou Lady was pushing a flotilla of six empty hopper barges destined for a scrap yard in Morgan City, Louisiana, when the forward portside barge struck the southern fixed section of the pontoon Bayou Blue Bridge near Houma, Louisiana about 0630 on December 7, 2013. Repairs to the bridge are estimated at more than $715,000. The Bayou Lady was undamaged; the lead barge sustained minor damage which was deemed inconsequential due to its destination for scrap. No injuries or pollution resulted from the accident. The National Transportation Safety Board determines that the probable cause of the allision of the Bayou Lady tow with Bayou Blue Bridge was the decision of the captain to transit the bridge opening in windy conditions and the reported temporary loss of steering control after the rudder was fouled by submerged debris. KW - Allisions KW - Crash causes KW - Crash investigation KW - Houma (Louisiana) KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1423.pdf UR - https://trid.trb.org/view/1341301 ER - TY - RPRT AN - 01549011 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire on Board Towing Vessel Shanon E. Settoon PY - 2014/12/10 SP - 6p AB - On March 12, 2013, at 1745 local time, the towing vessel Shanon E. Settoon was pushing a loaded tank barge in Bayou Perot (about 20 miles south of New Orleans, Louisiana) when it struck a submerged pipeline. The collision caused a release of liquefied petroleum gas, which entered the air intake for the main propulsion engines and ignited. The Shanon E. Settoon was destroyed by the fire; the tank barge had limited fire damage and did not release any of the 93,000 gallons of crude oil it was carrying. The four crewmembers on board the Shanon E. Settoon escaped from the vessel, but one of them sustained second- and third-degree burns from which he died 1 month later. The National Transportation Safety Board determines that the probable cause of the explosion and fire on board the Shanon E. Settoon was the introduction of petroleum gas into the main engines after the vessel struck and ruptured a submerged pipeline due to incomplete navigational information provided to the captain by the vessel company. KW - Crash investigation KW - Fires KW - Louisiana KW - Marine safety KW - Pipeline safety KW - Pipelines KW - Tank barges KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1422.pdf UR - https://trid.trb.org/view/1336273 ER - TY - RPRT AN - 01548643 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of BNSF Railway Company and Union Pacific Railroad Trains Near Keithville, Louisiana PY - 2014/12/01 SP - 5p AB - On Monday, December 30, 2013, at 6:37 a.m. central standard time, southbound Union Pacific Railroad (UP) freight train MPBSR 30 collided head on with BNSF Railway Company (BNSF) train CMNRNAJ 23. The collision happened at milepost (MP) 218.5 near Keithville, Louisiana, which is about 20 miles south of Shreveport, Louisiana, on the UP Lufkin Subdivision. The three leading locomotives and one car from the UP train derailed. Two locomotives and 11 cars from the BNSF train derailed. At the time of the accident, it was dark and overcast with visibility of about 10 miles. The temperature was 37°F. There were three crewmembers aboard each train. All of the UP crewmembers and one BNSF crewmember were injured. There was no significant fire or release of hazardous materials. Damages were estimated at $7.8 million. The National Transportation Safety Board determines that the probable cause of the accident was the BNSF train conductor's improper positioning of a switch for movement into the siding occupied by the BNSF train. KW - BNSF Railway KW - Crash causes KW - Crash investigation KW - Crashes KW - Keithville (Louisiana) KW - Railroad crashes KW - Railroad safety KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1414.pdf UR - https://trid.trb.org/view/1334425 ER - TY - RPRT AN - 01548527 AU - National Transportation Safety Board TI - Aircraft Incident Report: Auxiliary Power Unit Battery Fire, Japan Airlines Boeing 787-8, JA829J, Boston, Massachusetts, January 7, 2013 PY - 2014/11/21 SP - 110p AB - This report discusses the January 7, 2013, incident involving a Japan Airlines Boeing 787-8, JA8297, which was parked at a gate at General Edward Lawrence Logan International Airport, Boston, Massachusetts, when maintenance personnel observed smoke coming from the lid of the auxiliary power unit battery case, as well as a fire with two distinct flames at the electrical connector on the front of the case. No passengers or crewmembers were aboard the airplane at the time, and none of the maintenance or cleaning personnel aboard the airplane was injured. Safety issues relate to cell internal short circuiting and the potential for thermal runaway of one or more battery cells, fire, explosion, and flammable electrolyte release; cell manufacturing defects and oversight of cell manufacturing processes; thermal management of large-format lithium-ion batteries; insufficient guidance for manufacturers to use in determining and justifying key assumptions in safety assessments; insufficient guidance for Federal Aviation Administration (FAA) certification engineers to use during the type certification process to ensure compliance with applicable requirements; and stale flight data and poor-quality audio recording of the 787 enhanced airborne flight recorder. The National Transportation Safety Board (NTSB) determines that the probable cause of this incident was an internal short circuit within a cell of the APU lithium-ion battery, which led to thermal runaway that cascaded to adjacent cells, resulting in the release of smoke and fire. The incident resulted from Boeing’s failure to incorporate design requirements to mitigate the most severe effects of an internal short circuit within an APU battery cell and the FAA’s failure to identify this design deficiency during the type design certification process. As a result of this investigation, the NTSB makes safety recommendations to the FAA, Boeing, and GS Yuasa. The NTSB previously issued safety recommendations to the FAA regarding (1) insufficient testing methods and guidance for addressing the safety risks of internal short circuits and thermal runaway and (2) the need for outside technical knowledge and expertise to help the FAA ensure the safe introduction of new technology into aircraft designs. KW - Air transportation crashes KW - Boston (Massachusetts) KW - Crash investigation KW - Fire KW - Fire causes KW - Japan Airlines KW - Lithium batteries UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AIR1401.pdf UR - https://trid.trb.org/view/1333140 ER - TY - RPRT AN - 01548521 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash Following In-Flight Fire, Fresh Air, Inc., Convair CV-440-38, N153JR, San Juan, Puerto Rico, March 15, 2012 PY - 2014/11/17 SP - 43p AB - This report discusses the March 15, 2012, accident involving a Convair CV-440-38, N153JR, operated by Fresh Air, Inc., which crashed into a lagoon about 1 mile east of the departure end of runway 10 at Luis Muñoz Marín International Airport, San Juan, Puerto Rico. The two pilots died, and the airplane was destroyed by impact forces. The National Transportation Safety Board (NTSB) determines that the probable cause of this accident was the flight crew's failure to maintain adequate airspeed after shutting down the right engine due to an in-flight fire in one of the right augmentors. The failure to maintain airspeed resulted in either an aerodynamic stall or a loss of directional control. Safety issues include inadequate Federal Aviation Administration (FAA) oversight of 14 Code of Federal Regulations (CFR) Part 125 operations, inadequate evaluation of Fresh Air’s compliance with FAA-approved procedures, and evaluation of 14 CFR Part 125 pilots using another operator’s operations specifications. KW - Air transportation crashes KW - Airspeed KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fire KW - San Juan (Puerto Rico) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1404.pdf UR - https://trid.trb.org/view/1333141 ER - TY - RPRT AN - 01545298 AU - National Transportation Safety Board TI - Marine Accident Brief: Breakaway of Tanker Harbour Feature from its Moorings and Subsequent Allision with the Sarah Mildred Long Bridge PY - 2014/11/12 SP - 8p AB - On April 1, 2013, at 1324 local time, the 473-foot-long tanker Harbour Feature, with 20 persons on board, allided with the Sarah Mildred Long Bridge in Portsmouth, New Hampshire, after the vessel broke free from its moorings at the New Hampshire State Port Authority, Marine Terminal Wharf. No injuries or pollution resulted from the accident. The bridge sustained $2.5 million in damage; the Harbour Feature sustained $1 million in damage. The National Transportation Safety Board determines that the probable cause of the breakaway of the Harbour Feature from its moorings and subsequent allision with the Sarah Mildred Long Bridge was the inadequate mooring arrangement made by the master and the pilot for the vessel's location and the prevailing tidal conditions. KW - Allisions KW - Crash causes KW - Crash investigation KW - Mooring KW - Moorings KW - Portsmouth (New Hampshire) KW - Tankers KW - Water transportation crashes KW - Wharves UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1421.pdf UR - https://trid.trb.org/view/1331884 ER - TY - RPRT AN - 01548540 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash Following Encounter with Instrument Meteorological Conditions After Departure from Remote Landing Site, Alaska Department of Public Safety, Eurocopter AS350 B3, N911AA, Talkeetna, Alaska, March 30, 2013 PY - 2014/11/05 SP - 87p AB - This report discusses the March 30, 2013, accident involving a Eurocopter AS350 B3 helicopter, N911AA, operated by the Alaska Department of Public Safety, which impacted terrain while maneuvering during a search and rescue flight near Talkeetna, Alaska. The airline transport pilot, an Alaska state trooper serving as a flight observer for the pilot, and a stranded snowmobiler who had requested rescue were killed, and the helicopter was destroyed by impact and postcrash fire. Safety issues include inadequate pilot decision-making and risk management; lack of organizational policies and procedures to ensure proper risk management; inadequate pilot training, particularly for night vision goggle use and inadvertent instrument meteorological condition encounters; inadequate dispatch and flight following; lack of a tactical flight officer program; punitive safety culture; lack of management support for safety programs; and attitude indicator limitations. The National Transportation Safety Board determines that the probable cause of this accident was the pilot's decision to continue flight under visual flight rules into deteriorating weather conditions, which resulted in the pilot's spatial disorientation and loss of control. Also causal was the Alaska Department of Public Safety's punitive culture and inadequate safety management, which prevented the organization from identifying and correcting latent deficiencies in risk management and pilot training. Contributing to the accident was the pilot's exceptionally high motivation to complete search and rescue missions, which increased his risk tolerance and adversely affected his decision-making. Safety recommendations are addressed to the Federal Aviation Administration, the state of Alaska, 44 additional states, the Commonwealth of Puerto Rico, and the District of Columbia. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fires KW - Helicopters KW - Risk assessment KW - Search and rescue operations KW - Talkeetna (Alaska) KW - Weather conditions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1403.pdf UR - https://trid.trb.org/view/1333138 ER - TY - RPRT AN - 01548632 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding and Sinking of the Harbor Tug Kaleen McAllister PY - 2014/11/03 SP - 9p AB - Near sunset on the evening of May 4, 2013, the harbor assist tug Kaleen McAllister got underway from its berth in Baltimore Harbor with a crew of three to assist in docking a tow and barge entering the port. A few minutes later, the tug struck the charted edge of an adjacent collapsed pier and began flooding. The tug returned to its berth, where the crew and shoreside support personnel attempted to control the flooding, but the effort was unsuccessful and the vessel sank alongside the pier within 30 minutes. No one was injured; the sinking resulted in the discharge of about 2,400 gallons of diesel fuel and estimated vessel repair costs of $1.5 million. The National Transportation Safety Board determines that the probable cause of the grounding and sinking of the harbor assist tug Kaleen McAllister was the mate's practice of transiting near a submerged portion of a collapsed pier, a known and charted underwater hazard, which ultimately resulted in the vessel striking the obstruction. KW - Baltimore (Maryland) KW - Baltimore Harbor KW - Groundings (Maritime crashes) KW - Maritime safety KW - Ship pilotage KW - Sinking (Oceanography) KW - Tugboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1420.pdf UR - https://trid.trb.org/view/1333137 ER - TY - RPRT AN - 01544672 AU - National Transportation Safety Board TI - Railroad Accident Brief: Metro-North Railroad Employee Fatality, Manhattan, New York, March 10, 2014 PY - 2014/10/24 SP - 7p AB - On March 10, 2014, at12:55 a.m. eastern daylight time, a Metro-North Railroad (Metro-North) electrician was fatally struck by northbound train No.897 near milepost 3.2 at Control Point 3 (CP3) interlocking in Manhattan, New York. Three employees were attempting to re-energize tracks that had been out of service for maintenance. Two of the workers cleared the approaching train, but the third worker was struck by the train. The National Transportation Safety Board determines that the probable cause of the accident was the miscommunication of the limits of on-track protection resulting from incomplete and inaccurate roadway worker job briefings. Contributing to the accident was use of a reference point for on-track protection (the AB Split) that was poorly understood by some of the workers on the track. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Manhattan (New York, New York) KW - Metro-North Railroad KW - Occupational safety KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1413.pdf UR - https://trid.trb.org/view/1329333 ER - TY - RPRT AN - 01544650 AU - National Transportation Safety Board TI - Railroad Accident Brief: Metro-North Railroad Derailment, Bronx, New York, December 1, 2013 PY - 2014/10/24 SP - 6p AB - On Sunday, December 1, 2013, at 7:19 a.m. eastern standard time, southbound Metro-North Railroad (Metro-North) passenger train 8808 derailed at milepost 11.35 on main track 2 of the Metro-North Hudson Line. The train originated in Poughkeepsie, New York, with a destination of Grand Central Station in New York, New York. The train consisted of seven passenger cars and one locomotive; the locomotive was at the rear of the train in a push configuration. All passenger cars and the locomotive derailed. The derailment occurred in a 6° left-hand curve where the maximum authorized speed was 30 mph. The train was traveling at 82 mph when it derailed. As a result of the derailment, 4 people died and at least 61 persons were injured. Metro-North estimated about 115 passengers were on the train at the time of the derailment.The National Transportation Safety Board determines that the probable cause of the accident was the engineer's noncompliance with the 30-mph speed restriction because he had fallen asleep due to undiagnosed severe obstructive sleep apnea exacerbated by a recent circadian rhythm shift required by his work schedule. Contributing to the accident was the absence of a Metro-North Railroad policy or a Federal Railroad Administration regulation requiring medical screening for sleep disorders. Also contributing to the accident was the absence of a positive train control system that would have automatically applied the brakes to enforce the speed restriction. Contributing to the severity of the accident was the loss of the window glazing that resulted in the fatal ejection of four passengers from the train. KW - Bronx (New York, New York) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Metro-North Railroad KW - Railroad crashes KW - Railroad safety KW - Sleep disorders UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1412.pdf UR - https://trid.trb.org/view/1329332 ER - TY - RPRT AN - 01544640 AU - National Transportation Safety Board TI - Railroad Accident Brief: Derailment and Subsequent Collision of Two Metro-North Passenger Trains, Bridgeport, Connecticut, May 17, 2013 PY - 2014/10/24 SP - 8p AB - On Friday, May 17, 2013, at 6:01 p.m. eastern daylight time, eastbound Metro-North Railroad (Metro-North) passenger train 1548, which had departed Grand Central Terminal (GCT), New York, New York, headed toward New Haven, Connecticut, derailed from main track 4 at milepost (MP) 53.25 on the New Haven Line Subdivision 7.The derailed train was then struck by westbound Metro-North passenger train 1581, which had departed New Haven, Connecticut, bound for GCT. As a result of the collision, at least 65 persons were injured. Metro-North estimated about 250 passengers were on each train at the time of the accident. The National Transportation Safety Board determined that the probable cause of the derailment was an undetected broken pair of compromise joint bars on the north rail of track 4 on the Metro-North Railroad New Haven subdivision at milepost 53.25 resulting from: (1) the lack of a comprehensive track maintenance program that prioritized the inspection findings to schedule proper corrective maintenance; (2) the regulatory exemption for high-density commuter railroads from the requirement to traverse the tracks they inspect; and (3) Metro-North's decisions to defer scheduled track maintenance. KW - Bridgeport (Connecticut) KW - Crash causes KW - Crash investigation KW - Derailments KW - Maintenance of way KW - Metro-North Railroad KW - Railroad crashes KW - Railroad safety KW - Tie bars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1409.pdf UR - https://trid.trb.org/view/1329329 ER - TY - RPRT AN - 01544634 AU - National Transportation Safety Board TI - Railroad Accident Brief: Metro-North Railroad Employee Fatality, West Haven, Connecticut, May 28, 2013 PY - 2014/10/24 SP - 7p AB - On May 28, 2013, at 11:57 a.m. eastern daylight time, Metro-North Railroad (Metro-North) passenger train 1559, which was traveling westbound at 70 mph on the New Haven Line main track 1, struck and killed a track foreman in West Haven, Connecticut. The accident location was about 100 feet west of catenary bridge 1021 at milepost 69.56. The National Transportation Safety Board determines that the probable cause of this accident was the student rail traffic controller's removal (while working without direct supervision) of signal blocking protection for the track segment occupied by the track foreman and the failure of Metro-North to use any redundant feature to prevent this single point failure. Contributing to the accident was the Federal Railroad Administration's failure to require redundant signal protection, as recommended by Safety Recommendation R-08-6. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Metro-North Railroad KW - Occupational safety KW - Railroad crashes KW - Railroad safety KW - West Haven (Connecticut) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1410.pdf UR - https://trid.trb.org/view/1329330 ER - TY - RPRT AN - 01544578 AU - National Transportation Safety Board TI - Railroad Accident Brief Metro-North Railroad Derailment, Bronx, New York, July 18, 2013 PY - 2014/10/24 SP - 11p AB - On July 18, 2013, at 8:29 p.m. eastern daylight time, northbound CSX Transportation (CSX) train Q70419, derailed on the Metro-North Railroad (Metro-North) Hudson Line at milepost (MP) 9.99 on main track 2.1 The train consisted of 2 locomotives and 24 modified flat cars. Each flat car was loaded with 4 containers containing municipal refuse. The 11th through 20th cars derailed. The National Transportation Safety Board determines that the probable cause of the accident was excessive track gage due to a combination of fouled ballast, deteriorated concrete ties, and profile deviations resulting from Metro-North's decision to defer scheduled track maintenance. KW - Bronx (New York, New York) KW - Crash causes KW - Crash investigation KW - Derailments KW - Maintenance of way KW - Metro-North Railroad KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1411.pdf UR - https://trid.trb.org/view/1329331 ER - TY - RPRT AN - 01544557 AU - National Transportation Safety Board TI - Highway Accident Report: Highway–Railroad Grade Crossing Collision, Rosedale, Maryland, May 28, 2013 PY - 2014/10/08 SP - 95p AB - On May 28, 2013, about 1:59 p.m., a 2003 Mack Granite truck, operated by Alban Waste, LLC, was traveling northwest on a private road in Rosedale, Maryland, toward a private grade crossing. The truck was carrying a load of debris to a recycling center located 3.5 miles from the carrier terminal. About the same time, a CSX Transportation Company (CSXT) freight train—which consisted of two locomotives, 31 empty cars, and 14 loaded cars—was traveling southwest at a speed of 49 mph. As the train approached the crossing, the train horn sounded three times. The truck did not stop and was hit by the train. Three of the 15 derailed cars contained hazardous materials. The other derailed cars contained non-US Department of Transportation-regulated commodities, or were empty. One car loaded with sodium chlorate crystal and four cars loaded with terephthalic acid released their products. Following the derailment, a postcrash fire resulted in an explosion at 2:04 p.m., which caused widespread property damage. The fire remained confined to the derailed train cars. The truck driver was seriously injured in the collision. Three workers in a building adjacent to the railroad tracks and a Maryland Transportation Authority police officer who responded to the initial incident received minor injuries as a result of the explosion. Major safety issues identified in this investigation were distraction, federal oversight of new entrant motor carriers, obstructive sleep apnea, safety systems at private grade crossings, and oxidizing and flammable or combustible materials. The National Transportation Safety Board makes recommendations to the Federal Motor Carrier Safety Administration; the Federal Railroad Administration; the 50 states, the District of Columbia, and the Commonwealth of Puerto Rico; the Association of American Railroads; the American Short Line and Regional Railroad Association; the National Fire Protection Association; and CSXT. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - CSX Transportation KW - Derailments KW - Fires KW - Freight trains KW - Hazardous materials KW - Railroad grade crossings KW - Rosedale (Maryland) KW - Truck crashes KW - Trucking safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1402.pdf UR - https://trid.trb.org/view/1329325 ER - TY - RPRT AN - 01541444 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Bulk Carrier Herbert C. Jackson with the Jefferson Avenue Bridge, Rouge River, near Detroit, Michigan PY - 2014/10/01 SP - 5p AB - About 0212 on May 12, 2013, the bulk carrier Herbert C. Jackson was cleared for passage through the Jefferson Avenue Bridge over the Rouge River about 6 miles southwest of Detroit, Michigan, when the bridge tender, who was legally intoxicated at the time, lowered the drawbridge, striking the bulk carrier's bow. Damage to the vessel was estimated at $5,000. The bridge, a registered historic structure, was extensively damaged and expected to remain closed until 2015 for repair and restoration. No one was injured. The National Transportation Safety Board determines that the probable cause of the allision of the Herbert C. Jackson with the Jefferson Avenue Bridge was the intoxicated bridge tender's closing of the drawbridge as the vessel began its transit through the open bridge span. KW - Allisions KW - Bulk carriers KW - Crash causes KW - Crash investigation KW - Detroit (Michigan) KW - Drawbridges KW - Intoxication KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1419.pdf UR - https://trid.trb.org/view/1328014 ER - TY - RPRT AN - 01541483 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Oceanographic Research Vessel Seaprobe PY - 2014/09/25 SP - 6p AB - About 0315 local time on January 18, 2013, the oceanographic research vessel Seaprobe sank in the Gulf of Mexico, about 130 nautical miles south-southeastof Mobile, Alabama. Before the vessel sank, all 12 crewmembers evacuated to inflatable liferafts from which the United States Coast Guard rescued them shortly thereafter. Three crewmembers were injured. The National Transportation Safety Board determines that the probable cause of the flooding and subsequent sinking of the Seaprobe was the decision of the vessel owner to delay making permanent repairs to the starboard-side exhaust trunk and covering six of the vessel's freeing ports, leaving the Seaprobe susceptible to downflooding from boarding seas. Contributing to the accident was the owner's failure to comply with the vessel's safety management system and mandatory load line regulations. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Mobile (Alabama) KW - Oceanographic vessels KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1418.pdf UR - https://trid.trb.org/view/1328013 ER - TY - RPRT AN - 01544570 AU - National Transportation Safety Board TI - Special Investigation Report on Railroad and Rail Transit Roadway Worker Protection PY - 2014/09/24 SP - 68p AB - During 2013, 11 railroad roadway workers died while doing their jobs, representing the largest number of railroad roadway workers killed while on duty in one year since 1995, when 12 died. Also in 2013, four rail transit roadway workers died. This special investigation report describes the results of a National Transportation Safety Board (NTSB) investigation of these 15 deaths. The report identifies and discusses the circumstances of these deaths, which included falls from bridges, incidents involving bucket lifts, strikes by moving equipment, and natural hazards, including a mudslide. The report also identifies the following recurring safety issues: job briefings, regulation and safety oversight, the Fatality Analysis of Maintenance-of-Way Employees and Signalmen Committee, and safety culture and safety management systems. Safety recommendations to the Federal Railroad Administration, the Federal Transit Administration, the Occupational Safety and Health Administration, and the Fatality Analysis of Maintenance-of-Way Employees and Signalmen Committee are included. KW - Crash causes KW - Falls KW - Fatalities KW - Lifting equipment KW - Occupational safety KW - Rail transit KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Regulation KW - Safety management UR - https://app.ntsb.gov/doclib/safetystudies/SIR1403.pdf UR - https://trid.trb.org/view/1329328 ER - TY - RPRT AN - 01541423 AU - National Transportation Safety Board TI - Railroad Accident Brief: Norfolk Southern Railway Company Train Derailment and Hazardous Materials Release, Columbus, Ohio, July 11, 2012 PY - 2014/09/18 SP - 13p AB - On July 11, 2012, at 2:03 a.m. eastern daylight time, eastbound Norfolk Southern Railway Company (NS) freight train 186L809 derailed 17 cars on the NS Sandusky District at milepost (MP) S2.2 on main track 1. The derailment occurred on the NS Lake Division and within the city limits of Columbus, Ohio. The train consisted of 2 leading locomotives, 97 loaded freight cars, and 1 empty freight car. The derailment destroyed both main tracks (1 and 2). The 3rd through the 19th cars derailed. Cars 12 through 14 contained denatured ethanol (a hazardous material). One of these tank cars was punctured during the derailment. The denatured ethanol from this punctured tank car fueled a large pool fire. The two other tank cars that were carrying denatured ethanol were engulfed in the pool fire and split open. Witnesses observed multiple energetic fire eruptions when these two tank cars ruptured. The train crew was not injured; however, one person near the derailment site sustained minor burns. About 100 people in a 1-mile radius of the derailment were evacuated. The damages were estimated to total $1.2 million. At the time of the accident, the sky was clear, and the temperature was 70°F. The National Transportation Safety Board determines that the probable cause of the accident was a broken rail that exhibited evidence of rolling contact fatigue. KW - Columbus (Ohio) KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Derailments KW - Ethanol KW - Fires KW - Freight trains KW - Hazardous materials KW - Norfolk Southern Railway Company KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1408.pdf UR - https://trid.trb.org/view/1325018 ER - TY - RPRT AN - 01541487 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash During a Nighttime Nonprecision Instrument Approach to Landing, UPS Flight 1354, Airbus A300-600, N155UP, Birmingham, Alabama, August 14, 2013 PY - 2014/09/09 SP - 170p AB - On August 14, 2013, about 0447 central daylight time (CDT), UPS flight 1354, an Airbus A300-600, N155UP, crashed short of runway 18 during a localizer nonprecision approach to runway 18 at Birmingham-Shuttlesworth International Airport (BHM), Birmingham, Alabama. The captain and first officer were fatally injured, and the airplane was destroyed by impact forces and postcrash fire. The scheduled cargo flight was operating under the provisions of 14 Code of Federal Regulations Part 121 on an instrument flight rules flight plan, and dark night visual flight rules conditions prevailed at the airport; variable instrument meteorological conditions with a variable ceiling were present north of the airport on the approach course at the time of the accident. The flight originated from Louisville International Airport-Standiford Field, Louisville, Kentucky, about 0503 eastern daylight time. A notice to airmen in effect at the time of the accident indicated that runway 06/24, the longest runway available at the airport and the one with a precision approach, would be closed from 0400 to 0500 CDT. Because the flight's scheduled arrival time was 0451, only the shorter runway 18 with a nonprecision approach was available to the crew. Forecasted weather at BHM indicated that the low ceilings upon arrival required an alternate airport, but the dispatcher did not discuss the low ceilings, the single-approach option to the airport, or the reopening of runway 06/24 about 0500 with the flight crew. Further, during the flight, information about variable ceilings at the airport was not provided to the flight crew. The National Transportation Safety Board determines that the probable cause of this accident was the flight crew's continuation of an unstabilized approach and their failure to monitor the aircraft's altitude during the approach, which led to an inadvertent descent below the minimum approach altitude and subsequently into terrain. Contributing to the accident were (1) the flight crew's failure to properly configure and verify the flight management computer for the profile approach; (2) the captain's failure to communicate his intentions to the first officer once it became apparent the vertical profile was not captured; (3) the flight crew's expectation that they would break out of the clouds at 1,000 feet above ground level due to incomplete weather information; (4) the first officer's failure to make the required minimums callouts; (5) the captain's performance deficiencies likely due to factors including, but not limited to, fatigue, distraction, or confusion, consistent with performance deficiencies exhibited during training; and (6) the first officer's fatigue due to acute sleep loss resulting from her ineffective off-duty time management and circadian factors. KW - Air transportation crashes KW - Approach KW - Aviation safety KW - Birmingham (Alabama) KW - Cargo aircraft KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fatigue (Physiological condition) KW - Nighttime crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1402.pdf UR - https://trid.trb.org/view/1325017 ER - TY - RPRT AN - 01539457 AU - National Transportation Safety Board TI - Drug Use Trends in Aviation: Assessing the Risk of Pilot Impairment PY - 2014/09/09/Safety Study SP - 71p AB - This safety study examined trends in the prevalence of over-the-counter, prescription, and illicit drugs identified by toxicology testing of fatally injured pilots between 1990 and 2012. Safety issue areas identified during the study include (1) enhancing the precautionary information about potentially impairing drugs and conditions provided to pilots; (2) improving information about active pilots without medical certificates; (3) enhancing communication among prescribers, pharmacists, and patients about the transportation safety risks associated with some drugs and medical conditions; (4) developing and publicizing additional Federal Aviation Administration policy regarding marijuana use; and (5) researching the relationship between drug use and accident risk. As a result of this safety study, the National Transportation Safety Board makes recommendations to the Federal Aviation Administration and the 50 states, the District of Columbia, and the Commonwealth of Puerto Rico. KW - Air pilots KW - Crash risk forecasting KW - Drug use KW - Fatalities KW - Marijuana KW - Toxicology KW - Trend (Statistics) UR - http://www.ntsb.gov/safety/safety-studies/Documents/SS1401.pdf UR - https://trid.trb.org/view/1324564 ER - TY - RPRT AN - 01541407 AU - National Transportation Safety Board TI - Marine Accident Brief: Capsizing of Towing Vessel Megan McB PY - 2014/09/04 SP - 6p AB - On July 3, 2013, at 0558 local time, the uninspected towing vessel Megan McB lost engine throttle control while the crew was trying to maneuver the vessel into the main lock of Lock and Dam 7 on the Mississippi River near La Crescent, Minnesota. Without engine throttle control to maneuver the vessel, the strong river current swept the Megan McB into gate no. 1 of the dam, where the vessel became pinned and capsized. One crewmember died in the accident. The vessel was later refloated; its damage was estimated at $500,000. The National Transportation Safety Board determines that the probable cause of the capsizing of towing vessel Megan McB was the replacement pilot's unfamiliarity with the vessel's electronic engine control throttles, which resulted in his inability to avoid gate no. 1 of Lock and Dam 7. Contributing to the capsizing was Brennan Marine's lack of effective procedures to ensure that the Megan McB was operated by a replacement pilot familiar with the electronic engine control throttles, which were unique to this one vessel in the company fleet. KW - Capsizing KW - Crash causes KW - Crash investigation KW - Fatalities KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1417.pdf UR - https://trid.trb.org/view/1325019 ER - TY - RPRT AN - 01538274 AU - National Transportation Safety Board TI - Marine Accident Brief: Capsizing and Sinking of the Fishing Vessel Advantage PY - 2014/08/20 SP - 5p AB - The uninspected fishing vessel Advantage was on a routine transit from Kodiak harbor, Alaska,to fishing grounds off the southern coast of Kodiak Island with a load of empty cod pots when it sank about 14 nautical miles southwest of Cape Barnabas at 0030 on August 31, 2012. A Coast Guard rescue helicopter retrieved three of the four crewmembers. One was never found and was presumed dead, and the vessel's captain later died. About 3,453 gallons of diesel fuel were onboard the vessel when it sank. The National Transportation Safety Board determines that the probable cause of the capsizing and sinking of the fishing vessel Advantage was a severe heel to port, followed by immediate downflooding. The reason for the vessel's loss of stability could not be determined. KW - Alaska KW - Capsizing KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Sinking (Oceanography) KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1416.pdf UR - https://trid.trb.org/view/1322493 ER - TY - RPRT AN - 01536071 AU - National Transportation Safety Board TI - Railroad Accident Brief: CSX Transportation Coal Train Derailment Killed Two Individuals, Ellicott City, Maryland, August 20, 2012 PY - 2014/07/31 SP - 19p AB - On August 20, 2012, about 11:54 p.m. eastern daylight time, an eastbound CSX Transportation (CSXT) coal train, U81318, derailed the first 21 cars at milepost (MP) 12.9 while crossing the railroad bridge over Main Street on the Old Main Line (OML) Subdivision in Ellicott City, Maryland. The train consisted of two locomotives and 80 loaded coal cars; the train length was 4,227 feet and the weight was 9,873 trailing tons. Seven of the derailed cars fell into a public parking area that was below and north of the tracks. The remainder of the derailed cars overturned and spilled coal along the north side of the tracks. Prior to the train crossing the bridge, two individuals entered the railroad right-of-way on the north side of the railroad bridge that crossed Main Street. They climbed over a short wooden fence and entered CSXT property without authorization to access the railroad bridge. They were sitting on the bridge during the derailment. Both individuals were killed by the spilled coal. The CSXT train crew consisted of an engineer, a conductor, and an engineer trainee. No crewmembers were injured. At the time of the accident, the sky was cloudy and dark, the wind was calm, and the temperature was 65°F. The damage was estimated to be $1.9 million. The CSXT train crew reported for duty at 4:00 p.m. on August 20, 2012, in Cumberland, Maryland. The train departed Cumberland eastbound toward Baltimore, Maryland. The National Transportation Safety Board determines that the probable cause of the Ellicott City derailment was a broken rail with evidence of rolling contact fatigue. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - CSX Transportation KW - Derailments KW - Ellicott City (Maryland) KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1407.pdf UR - https://trid.trb.org/view/1320979 ER - TY - RPRT AN - 01538141 AU - National Transportation Safety Board TI - Railroad Accident Report: Conrail Freight Train Derailment with Vinyl Chloride Release, Paulsboro, New Jersey, November 30, 2012 PY - 2014/07/29 SP - 90p AB - This report discusses the 2012 accident in which a Consolidated Rail Corporation (Conrail) train derailed while traveling over a moveable bridge in Paulsboro, New Jersey. Three tank cars containing vinyl chloride came to rest in Mantua Creek, of which one was breached and released about 20,000 gallons of vinyl chloride. On that day, 28 residents sought medical attention for possible exposure, and the train crew and many emergency responders were also exposed. Damage estimates were $451,000 for equipment and about $30 million for emergency response and remediation. This report addresses safety issues: training and qualification of train crews for moveable bridge inspection; Conrail safety management; timeliness of hazardous materials communications to first responders; failure of the incident commanders to follow established hazardous materials response protocols; firefighter training and qualifications; inadequacies of emergency planning, emergency preparedness, and public awareness for hazardous materials transported by train; and rail corridor risk management analysis. As a result of this investigation, the National Transportation Safety Board makes safety recommendations to the US Department of Transportation, the Federal Railroad Administration, the Pipeline and Hazardous Materials Safety Administration, Consolidated Rail Corporation, the Association of American Railroads, the American Short Line and Regional Railroad Association, the International Association of Fire Chiefs, the National Volunteer Fire Council, the New Jersey State Police Office of Emergency Management, the New Jersey Bureau of Fire Department Services, the New Jersey Department of Labor and Workforce Development, and the New Jersey Department of Health. The National Transportation Safety Board also reiterates recommendations to the Federal Railroad Administration and the Pipeline and Hazardous Materials Safety Administration. KW - Consolidated Rail Corporation (Conrail) KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Derailments KW - Freight trains KW - Hazardous materials KW - Paulsboro (New Jersey) KW - Polyvinyl chloride KW - Railroad bridges KW - Railroad crashes KW - Railroad safety KW - Spills (Pollution) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1401.pdf UR - https://trid.trb.org/view/1322135 ER - TY - RPRT AN - 01536053 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Fishing Vessel Long Shot PY - 2014/07/25 SP - 6p AB - On November 15, 2013, as the 72.1-foot-long commercial fishing vessel Long Shot was returning from a 2-week fishing trip, its main propulsion diesel engine and electrical generator engines failed 150 nautical miles southwest of Panama City, Florida in the Gulf of Mexico. Without propulsion and steering to control the vessel's heading, boarding seas hit the stern, and an aft compartment flooded. For several hours, the crew tried to save the sinking Long Shot but ultimately needed to be evacuated by the United States Coast Guard. No one was injured, but the vessel, valued at $150,000, was a total loss. The National Transportation Safety Board determines that the probable cause of the sinking of fishing vessel Long Shot was water contamination of its fuel oil storage tanks, which led to failure of the propulsion and electrical generator engines and flooding of the lazarette compartment in heavy seas. Contributing to the sinking was excessive water leakage at the rudder post packing gland, which led to the initial flooding of the lazarette compartment. KW - Crash analysis KW - Crash investigation KW - Fishing vessels KW - Gulf of Mexico KW - Leakage KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/2014/MAB1415.pdf UR - https://trid.trb.org/view/1320976 ER - TY - RPRT AN - 01536078 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire On Board Motor Yacht Ocean Alexander 85E06 PY - 2014/07/15 SP - 6p AB - On July 10, 2013, about 1000 local time, the newly built motor yacht Ocean Alexander 85E06 was moored, unmanned, and on display for purchase at the Roche Harbor Resort Marina in Washington state when a fire broke out in a forward compartment. Efforts to extinguish the fire were unsuccessful and the flames consumed the vessel. In addition, the vessel partially sank due to flooding from firefighting activities. No one was injured, but about 400 gallons of marine diesel fuel spilled into the waterway. The yacht, valued at $3,691,660, was a total loss. The National Transportation Safety Board determines that the probable cause of the fire on board the Ocean Alexander 85E06 was an electrical fault of an unknown source, located in the vessel's forward accommodation area. KW - Crash investigation KW - Fire causes KW - Fires KW - Marine safety KW - Washington (State) KW - Water transportation crashes KW - Yachts UR - http://app.ntsb.gov/doclib/reports/2014/MAB1414.pdf UR - https://trid.trb.org/view/1320977 ER - TY - RPRT AN - 01535729 AU - National Transportation Safety Board TI - Highway Accident Report: Collapse of the Interstate 5 Skagit River Bridge Following a Strike by an Oversize Combination Vehicle, Mount Vernon, Washington, May 23, 2013 PY - 2014/07/15 SP - 85p AB - On Thursday, May 23, 2013, about 7:05 p.m. Pacific daylight time, a 2010 Kenworth truck tractor in combination with a 1997 Aspen flatbed semitrailer hauling an oversize load was traveling south on Interstate 5 (I-5) near Mount Vernon, Washington. The oversize combination vehicle had a permit for the route of travel and was being led by a pilot/escort vehicle, a 1997 Dodge Ram pickup truck. As the oversize combination vehicle traveled across the I-5 bridge above the Skagit River, its oversize load struck the bridge, damaging the structure. As a result of contact damage to the bridge’s truss structure, span 8 of the 12-span bridge collapsed into the Skagit River. Two passenger vehicles, a southbound 2010 Dodge Ram pickup truck towing a Jayco travel-trailer and a northbound 2013 Subaru XV Crosstrek, fell into the river. Eight vehicle occupants were involved in the collapse; three received minor injuries and five were uninjured. The National Transportation Safety Board determines that the probable cause of the Interstate 5 Skagit River Bridge span collapse was a strike to the bridge structure by an oversize combination vehicle that failed to travel in a lane with adequate overhead clearance due to deficiencies in the interdependent system of safeguards for oversize load movements. These deficiencies included (1) insufficient route planning by Mullen Trucking LP and the oversize combination vehicle driver; (2) failure of the certified pilot/escort vehicle driver to perform required duties and to communicate potential hazards, due in part to distraction caused by cell phone use; and (3) inadequate evaluation of oversize load permit requests and no provision of low-clearance warning signs in advance of the bridge by the Washington State Department of Transportation. KW - Clearances (Navigation) KW - Collapse KW - Crash causes KW - Crash investigation KW - Distraction KW - Highway bridges KW - Mount Vernon (Washington) KW - Oversize loads KW - Permits KW - Tractor trailer combinations KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1401.pdf UR - https://trid.trb.org/view/1319865 ER - TY - RPRT AN - 01536075 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire and Explosions On Board Towing Vessel Safety Runner and Kirby Barges 28182 and 28194 PY - 2014/07/14 SP - 7p AB - On April 24, 2013, at 2030 local time, the towing vessel Safety Runner docked on the Mobile River in Mobile, Alabama, alongside two Kirby barges that were having their tanks cleaned. Shortly thereafter, flammable vapors being vented from the barges' open tank hatches entered the Safety Runner's engine room and ignited. The fire spread from the towing vessel to the barges, resulting in explosions. Three persons sustained serious burn injuries. The total damage to the vessel and barges was estimated at $5.7 million. The National Transportation Safety Board determines that the probable cause of the fire and explosions involving towing vessel Safety Runner and Kirby barges 28182 and 28194 was the failure of the Oil Recovery Company (ORC) Gas-Freeing Marine Terminal facility to isolate tank-cleaning operations from sources of ignition. Contributing to the accident was ORC's failure to provide its employees with tank-cleaning training and procedures that followed industry standards and government regulations for reducing the risk of fire during tank-cleaning operations. KW - Crash investigation KW - Explosions KW - Fire causes KW - Fires KW - Marine safety KW - Mobile River (Alabama) KW - Tank barges KW - Towboats KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/2014/MAB1413.pdf UR - https://trid.trb.org/view/1320978 ER - TY - RPRT AN - 01531507 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision Between Two Freight Trains, Barton County, Missouri, July 21, 2012 PY - 2014/07/03 SP - 7p AB - On July 21, 2012, about 3:30 p.m. central daylight time, Kansas City Southern Railway Company (KCS) freight train QSHKC20 collided with the side of BNSF Railway (BNSF) freight train EMHSEBM088 at a railroad crossing near Arcadia, Kansas. At the time of the collision, the BNSF train was traveling about 35 mph and the KCS train was traveling about 31 mph. The temperature at the time of the accident was 92°F and the weather was clear. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the train crew of Kansas City Southern Railway Company freight train QSHKC20 to comply with trackside signal indications. Contributing to the accident was the lack of a positive train control system that could have stopped the train, thereby preventing the accident. KW - Barton County (Missouri) KW - BNSF Railway KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Freight trains KW - Kansas City Southern Railway KW - Positive train control KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1405.pdf UR - https://trid.trb.org/view/1316794 ER - TY - RPRT AN - 01531504 AU - National Transportation Safety Board TI - Railroad Accident Brief: The Belt Railway Company of Chicago Employee Fatality, Bedford Park, Illinois, July 25, 2011 PY - 2014/07 SP - 5p AB - On Monday, July 25, 2011, about 12:33 a.m., central daylight time, a Belt Railway Company of Chicago (BRC) conductor was killed while coupling cars in a hump classification yard track in Bedford Park, Illinois. The accident occurred in the BRC Clearing Yard, West Classification Yard (WCLS) track 16. The conductor was found in the gage of the track between the 17th and 18th west railcars. The drawbars on these two railcars were found to be crossed. The conductor appeared to have been pinched between the knuckle of the stationary car that was coupled to the train and the drawbar carrier of the free-rolling car that he was attempting to couple. At the time of the accident, the weather was mostly cloudy; the temperature was 76°F. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the conductor to apply the necessary protections before he stepped between the cars to adjust the drawbars. Contributing to the cause of the accident was the BRC's lack of an effective efficiency testing program to periodically observe and enforce its safety and operating rules for switching movements. KW - Bedford Falls (Illinois) KW - Belt Railway of Chicago KW - Conductors (Trains) KW - Crash analysis KW - Crash investigation KW - Fatalities KW - Occupational safety KW - Railroad yards UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1406.pdf UR - https://trid.trb.org/view/1316743 ER - TY - RPRT AN - 01530938 AU - National Transportation Safety Board TI - Railroad Accident Brief: Union Pacific Railroad Employee Fatality, Mathis, Texas, September 4, 2013 PY - 2014/06/27 SP - 4p AB - On September 4, 2013, about 4:15 p.m., in Mathis, Texas, a Union Pacific Railroad (UP) welder was killed and another UP welder was seriously injured when an S-60 Trax aerial lift vehicle overturned. At the time of the accident, the temperature was 102° F, and the weather was clear. The accident occurred on the UP San Antonio Service Unit of the Corpus Christi Subdivision main line at milepost 106. The National Transportation Safety Board determines that the probable cause of the accident was the welders' attempt to free the snagged aerial lift bucket from within the bucket, in lieu of evacuating the bucket and using the ground controls. KW - Crash analysis KW - Crash investigation KW - Fatalities KW - Industrial accidents KW - Lifting equipment KW - Mathis (Texas) KW - Occupational safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1404.pdf UR - https://trid.trb.org/view/1315533 ER - TY - RPRT AN - 01530940 AU - National Transportation Safety Board TI - Railroad Accident Brief: Employee Fatality, BNSF Argentine Yard, Kansas City, Kansas, August 15, 2011 PY - 2014/06/25 SP - 5p AB - On August 15, 2011, about 1:12 p.m., central daylight time, a BNSF Railway (BNSF) yard crewmember was killed while coupling railcars in the BNSF Argentine Yard in Kansas City, Kansas. The accident occurred on the east end of track 23 in the classification yard. During the day of the accident, the weather was overcast and rainy. The temperature was 63°F. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the remote control operations crew to establish required protections before the helper entered the gap between the lead-end of a train and a cut of freestanding, rolling railcars. KW - BNSF Railway KW - Crash analysis KW - Crash investigation KW - Employees KW - Fatalities KW - Kansas City (Kansas) KW - Occupational safety KW - Railroad yards UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1403.pdf UR - https://trid.trb.org/view/1315535 ER - TY - RPRT AN - 01531885 AU - National Transportation Safety Board TI - Aircraft Accident Report: Descent Below Visual Glidepath and Impact With Seawall, Asiana Airlines Flight 214, Boeing 777-200ER, HL7742, San Francisco, California, July 6, 2013 PY - 2014/06/24 SP - 207p AB - This report discusses the July 6, 2013, accident involving a Boeing 777-200ER, Korean registration HL7742, operating as Asiana Airlines flight 214, which was on approach to runway 28L when it struck a seawall at San Francisco International Airport (SFO), San Francisco, California. Three of the 291 passengers were fatally injured; 40 passengers, 8 of the 12 flight attendants, and 1 of the 4 flight crewmembers received serious injuries. The other 248 passengers, 4 flight attendants, and 3 flight crewmembers received minor injuries or were not injured. The airplane was destroyed. Safety issues relate to the need for Asiana pilots to adhere to standard operating procedures regarding callouts; reduced design complexity and enhanced training on the airplane’s autoflight system; opportunity at Asiana for new instructors to supervise trainee pilots in operational service during instructor training; guidance for Asiana pilots on use of flight directors during a visual approach; more manual flight for Asiana pilots; a context-dependent low energy alert; research that examines the injury potential from significant lateral forces in airplane crashes and the mechanism that produces high thoracic spinal injuries; evaluation of the adequacy of slide/raft inertia load certification testing; aircraft rescue and firefighting (ARFF) training for officers in command of an aircraft accident response; guidance on when to use a skin-piercing nozzle on a burning airplane fuselage; integration of the medical supply buses at SFO into the airport’s preparation drills; guidance or protocols for ensuring the safety of passengers and crew at risk of a vehicle strike during ARFF operations; requirements for ARFF staffing; improvements in SFO emergency communications; and increased Federal Aviation Administration (FAA) oversight of SFO’s emergency procedures manual. Safety recommendations are addressed to the FAA, Asiana Airlines, Boeing, the ARFF Working Group, and the City of San Francisco. KW - Air transportation crashes KW - Asiana Airlines KW - Automatic pilot KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fires KW - San Francisco (California) KW - San Francisco International Airport KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1401.pdf UR - https://trid.trb.org/view/1316751 ER - TY - RPRT AN - 01530962 AU - National Transportation Safety Board TI - Railroad Accident Brief: Angels Flight Railway Derailment, Los Angeles, California, September 5, 2013 PY - 2014/06/23 SP - 5p AB - On September 5, 2013, about 11:30 a.m. pacific daylight time, an Angels Flight Railway (Angels Flight) car that was moving down the incline derailed near the middle of the guideway. One passenger was onboard the derailed car, and five passengers were onboard the stalled car that had been moving up the incline. The temperature was 93°F,and the weather was clear. No passengers were injured. The National Transportation Safety Board determines the probable cause of the September 5, 2013, accident was the intentional bypass of the funicular safety system with Angels Flight management knowledge; and Angels Flight management continuation of revenue operations despite prolonged, and repeated, unidentified system safety shutdowns. KW - Cable railroads KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Los Angeles (California) KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1402.pdf UR - https://trid.trb.org/view/1315532 ER - TY - RPRT AN - 01529285 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of the Dale A. Heller Tow with Marseilles Dam PY - 2014/06/13 SP - 6p AB - On April 18, 2013, about 1740 local time, the uninspected towing vessel Dale A. Heller was downbound on the Illinois River pushing a 14-barge tow and attempting to enter the Marseilles Canal, adjacent to the Marseilles Dam, when it encountered a strong cross current. Despite the assistance of three additional towing vessels, the Dale A. Heller was unable to get the tow past the dam and into the safety of the canal. Several barges broke away, struck and damaged the dam's gates, and then sank. In addition, the accident likely exacerbated rain-related flooding in the nearby city of Marseilles, Illinois. No one was injured in the allision; however, the damage to the barges and the dam totaled nearly $54 million. The National Transportation Safety Board determines that the probable cause of the allision of the Dale A. Heller tow with the Marseilles Dam was the decision by all involved parties to proceed with the passage of the tow during a period of record-high water and significant risk. Contributing to the accident was the failure of the Marseilles Dam lockmaster and the Dale A. Heller captain to communicate effectively about the actual positioning of the dam's gates before and during the transit. KW - Allisions KW - Barges KW - Crash causes KW - Crash investigation KW - Dams KW - Illinois River KW - Towboats KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/2014/MAB1411.pdf UR - https://trid.trb.org/view/1313789 ER - TY - RPRT AN - 01530987 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding of Commercial Towing Vessel Justice PY - 2014/05/29 SP - 7p AB - The towing vessel Justice was heading to Buzzards Bay, Massachusetts, with five crewmembers when it grounded on a hard, rocky bottom southwest of Cape Cod Canal, just outside Hog Island Channel on March 21, 2013. The impact, at 0001 eastern daylight time, sheared the starboard stern drive from the vessel and resulted in the discharge of 232 gallons of gear oil. The vessel docked 15 minutes later without further incident using its remaining port stern drive. No one was injured. The National Transportation Safety Board determines that the probable cause of the grounding of the commercial towing vessel Justice in Hog Island Channel was the mate's ineffective use of the vessel's autopilot to maintain a course within the navigable channel and his delay in taking manual control as the vessel approached charted hazards. KW - Buzzards Bay (Massachusetts) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Groundings (Maritime crashes) KW - Marine safety KW - Tugboats UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1410.pdf UR - https://trid.trb.org/view/1315534 ER - TY - RPRT AN - 01529333 AU - National Transportation Safety Board TI - Marine Accident Brief: Engine Room Fire On Board Fishing Vessel Arctic Storm PY - 2014/05/29 SP - 7p AB - On the afternoon of May 20, 2013, a fire broke out in the engine room of the uninspected fishing vessel Arctic Storm as it was under way in the North Pacific Ocean, about 46 nautical miles west of Aberdeen, Washington, conducting fish processing operations. The crew extinguished the fire through the combined use of portable extinguishers, fixed suppression, and fire hoses. No injuries or pollution resulted from the accident. The estimated damage to the Arctic Storm was $5 million. The National Transportation Safety Board determines that the probable cause of the fire on board fishing vessel Arctic Storm was a fractured fitting on a fuel oil vent valve, located on the main propulsion engine, which resulted in fuel oil spraying onto a hot engine surface and igniting. KW - Crash investigation KW - Fire KW - Fire causes KW - Fishing vessels KW - North Pacific Ocean KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/2014/MAB1409.pdf UR - https://trid.trb.org/view/1313790 ER - TY - RPRT AN - 01526285 AU - National Transportation Safety Board TI - Special Investigation Report on the Safety of Agricultural Aircraft Operations PY - 2014/05/07 SP - 36p AB - This special investigation report describes the results of a National Transportation Safety Board (NTSB) review of 78 accidents that occurred during calendar year 2013 and involved some aspect of agricultural (ag) operations, pilot training, or other crop protection activities. The report identifies the following recurring safety issues: lack of ag operations-specific fatigue management guidance, lack of ag operations-specific risk management guidance, inadequate aircraft maintenance, and lack of guidance for pilot knowledge and skills tests. Safety recommendations to the Federal Aviation Administration and to the National Agricultural Aviation Research & Education Foundation are included. The Appendix at the end of the report contains a full listing by NTSB case number of the accidents reviewed for the special investigation. KW - Agricultural aviation KW - Air pilots KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatigue (Physiological condition) KW - Recommendations KW - Risk management KW - Vehicle maintenance UR - https://app.ntsb.gov/doclib/safetystudies/SIR1401.pdf UR - https://trid.trb.org/view/1309824 ER - TY - RPRT AN - 01526425 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Towing Vessel Delta Captain PY - 2014/04/28 SP - 4p AB - On April 13, 2013, about 1455, the uninspected towing vessel Delta Captain, towing the deck barge DB 5, experienced uncontrolled flooding in its engine room and sank 13 nautical miles west of Point Sur, California. The four crewmembers abandoned the vessel within about 10 minutes after the flooding began and were later rescued by the United States Coast Guard. No one was injured in the accident, but the vessel sank in deep water and was not recovered. Its estimated value was $2.5 million. The National Transportation Safety Board determines that the probable cause of the sinking of the towing vessel Delta Captain was uncontrolled flooding of the steering gear space and engine room from an undetermined source in the steering gear space. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Towboats KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/2014/MAB1408.pdf UR - https://trid.trb.org/view/1309826 ER - TY - RPRT AN - 01526354 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Fishing Vessel Allison C PY - 2014/04/15 SP - 4p AB - On September 20, 2012, about 2030 local time, the 76-foot-long commercial fishing vessel Allison C sank about 125 miles off the coast of California, west-southwest of Point Piedras Blancas, after the vessel's engine room flooded. The three crewmembers and their cat abandoned the Allison C and were rescued without injury. The value of the vessel and its cargo was estimated as $277,000. The National Transportation Safety Board determines that the probable cause of the sinking of the Allison C was a loss of hull integrity from a leak in the engine room, which led to uncontrollable flooding. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fishing vessels KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1406.pdf UR - https://trid.trb.org/view/1309900 ER - TY - RPRT AN - 01526252 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Tanker Wawasan Ruby with CSX Bayside Coal Pier PY - 2014/04/15 SP - 5p AB - On August 25, 2012, about 1245 eastern daylight time, the 477-foot-long tanker Wawasan Ruby, with 24 persons on board, allided with the CSX Bayside Coal Pier (CSX Pier) in Baltimore Harbor, Maryland, while the tanker was making a turn toward its destination berth. One person on the pier was injured. The damage to the pier totaled more than $2 million; the Wawasan Ruby sustained an estimated $15,000 in damage. The National Transportation Safety Board determines that the probable cause of the allision of the tanker Wawasan Ruby with the CSX Bayside Coal Pier was the high rate of speed at which the pilot and the master were operating the vessel while attempting a 70-degree turn into Curtis Creek. KW - Allisions KW - Baltimore Harbor KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Speed KW - Tankers KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1407.pdf UR - https://trid.trb.org/view/1309827 ER - TY - RPRT AN - 01526427 AU - National Transportation Safety Board TI - Highway Accident Brief: Median Crossover Multivehicle Accident, Houston, Texas, January 7, 2013 PY - 2014/04/10 SP - 8p AB - About 8:40 a.m. central standard time, on January 7, 2013, a 2004 Toyota Camry passenger vehicle operated by a 37-year-old female driver was traveling southbound in the 14400 block of South Main Street in Houston, Texas. The Camry driver was returning home after completing a 13-hour shift as a nurse at a local hospital. The Camry was in the left lane of a three-lane divided roadway when the vehicle drifted to the left and departed the lane, mounted the curb, crossed over a 17-foot-wide earthen median, and entered the northbound lanes. The Camry struck the front left corner of a 2005 Lincoln LS passenger vehicle that was traveling northbound in the left lane on South Main Street. The initial collision redirected the Lincoln into the center lane of the northbound roadway, where it was subsequently struck in the rear by a 2000 Toyota Avalon passenger vehicle. Both the Lincoln and the Avalon traveled an additional 160 feet prior to coming to rest in the intersection of a side street. The Camry came to rest in the left lane of the northbound roadway. As a result of the crash, the driver of the Lincoln was fatally injured. The driver of the Camry was transported to an area hospital where she was treated for her injuries, and the driver of the Avalon was reportedly uninjured. All three drivers were restrained by three-point lap and shoulder belts. The National Transportation Safety Board determines that the probable cause of this crash was the Toyota Camry driver's failure to maintain directional control of her vehicle because of falling asleep. Contributing to the driver's fatigue was her inverted work schedule and her extended time since waking. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Fatigue (Physiological condition) KW - Highway safety KW - Houston (Texas) KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1402.pdf UR - https://trid.trb.org/view/1309903 ER - TY - RPRT AN - 01526363 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of the Passenger Vessel Seastreak Wall Street with Pier 11, Lower Manhattan, New York, New York, January 9, 2013 PY - 2014/04/08 SP - 58p AB - This report discusses the allision of the high-speed passenger ferry Seastreak Wall Street with Pier 11/Wall Street in lower Manhattan, New York City, on January 9, 2013. Four passengers were seriously injured, and 75 passengers and 1 deckhand sustained minor injuries. The estimated cost to repair the ferry was about $166,200. The total cost of repairs to the pier was $333,349. Safety issues identified in this report include oversight of vessel operations, control panel design, management of passenger access to stairwells to mitigate possible injuries, the importance of marine safety management systems, and the need for information captured by voyage data recorders in investigating and analyzing accident causes and identifying remedial actions to help prevent their recurrence. The National Transportation Safety Board (NTSB) issues new recommendations to the United States Coast Guard regarding human factors standards for critical vessel controls, the need for operator control of ferry passenger access to stairwells, and the carriage of marine voyage data recorders. The NTSB also recommends that the owner of the Seastreak Wall Street improve specific control system displays and alerts, complete development and implementation of a safety management system, and revise its vessel operations and training manuals. The NTSB asks the manufacturer of the vessel’s propulsion control system to improve its design and alert its customers to the changes. The report also reclassifies previous recommendations to the Coast Guard regarding safety management systems and voyage data recorders. KW - Allisions KW - Control panels KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Ferries KW - Injuries KW - New York (New York) KW - Recommendations KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1401.pdf UR - https://trid.trb.org/view/1309899 ER - TY - RPRT AN - 01526381 AU - National Transportation Safety Board TI - Railroad Accident Brief: Highway-Rail Grade Crossing Collision, Madison, Illinois, February 28, 2012 PY - 2014/03/27 SP - 13p AB - On February 28, 2012, at 11:57 a.m., southbound Amtrak train 301-28, traveling on Union Pacific Railroad (UP) Springfield Subdivision main track 2, collided with an eastbound vehicle at the Bissell Street highway-rail grade crossing (crossing) in Madison, Illinois. Two UP signal employees were working in the UP warning system signal bungalow for the crossing when the accident occurred. Locomotive video recorder data indicated that the crossing warning system did not activate before or during the collision. The vehicle driver died as a result of the collision. Amtrak train 301-28 was en route from Chicago, Illinois, to St. Louis, Missouri. The train did not derail. The train crewmembers and passengers did not sustain any injuries. Damages were estimated at $3,794. The temperature at the time of the accident was 48°F with partly cloudy skies and wind from the southeast at 2 mph. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the Union Pacific Railroad signal inspector and signal technician to provide for the safety of train movements and highway users prior to disabling the highway-rail grade crossing warning system at the Bissell Street crossing. Contributing to the accident was the failure of Union Pacific Railroad management to ensure proper procedures were followed during the software upgrades to provide for the safety of train movements and highway users. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Madison (Illinois) KW - Railroad crashes KW - Railroad grade crossings KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1401.pdf UR - https://trid.trb.org/view/1309904 ER - TY - RPRT AN - 01526402 AU - National Transportation Safety Board TI - Highway Accident Brief: Multivehicle Collision and Subsequent Vehicle Fall from Bridge PY - 2014/03/14 SP - 11p AB - On Friday, July 19, 2013, about 8:24 p.m., a 2007 Chrysler Sebring passenger car operated by a 24-year-old female driver was traveling eastbound on US Route 50/301 near Annapolis, Maryland. The Chrysler had passed through the toll plaza to enter onto the eastbound span of the William Preston Lane, Jr., Memorial Bridge (Chesapeake Bay Bridge). Less than a mile past the toll plaza, after vehicles had merged from 11 toll lanes into two travel lanes, traffic began to slow as the bridge ascended above the Chesapeake Bay and curved to the left. The Chrysler was in the right lane and had reduced speed to 4 mph due to the traffic queue ahead when it was struck from behind by a 2010 International truck-tractor and refrigerated semitrailer combination unit traveling 47 mph. The truck-tractor, operated by a 29-year-old male driver, collided with the left rear corner of the Chrysler, pushing it into the concrete barrier adjacent to the right lane. As the truck-tractor and the Chrysler continued forward, the front of the Chrysler collided with a 2014 Mazda CX-5 occupied by a 65-year-old male driver and his wife. During the collision sequence, the Chrysler was pushed up onto the barrier wall and then rode along the top of it, before falling approximately 27 feet into the Chesapeake Bay. The Chrysler came to rest between two bridge piers to the south of the eastbound span, in approximately 7 feet of water. The Mazda rotated counter-clockwise and came to rest near the left front corner of the truck-tractor in the middle of the two travel lanes. As a result of the collision, the driver of the Chrysler received minor injuries. She was able to swim to one of the nearby bridge piers, from which she was rescued and transported to an area hospital. The driver of the truck-tractor and both occupants of the Mazda were uninjured. Weather conditions were clear and dry, and it was near sunset at the time of the crash. The National Transportation Safety Board determines that the probable cause of the July 19, 2013, crash on the Chesapeake Bay Bridge was the failure of the truck-tractor driver to slow for traffic due to his inattention to the forward roadway while looking in his side view mirror. Contributing to the crash were the truck driver’s unfamiliarity with the area and lack of knowledge that traffic routinely slows on the eastbound span of the bridge after exiting the toll plaza and before entering the leftward curve. Contributing to the severity of the crash were the unusual collision dynamics that allowed for a passenger vehicle to be pushed over the barrier wall and into the water. KW - Chesapeake Bay Bridge KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Distraction KW - Multiple vehicle crashes KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1401.pdf UR - https://trid.trb.org/view/1309906 ER - TY - RPRT AN - 01526346 AU - National Transportation Safety Board TI - Marine Accident Brief: Foundering of the Fishing Vessel Moonlight Maid PY - 2014/03/14 SP - 7p AB - The wooden-hulled uninspected fishing vessel Moonlight Maid was transiting to Kodiak, Alaska, in heavy seas when the vessel sprung a plank and began flooding on September 20, 2012. The vessel's bilge pumps were unable to keep up with the rate of flooding, so the crew of four made a Mayday call, donned survival suits, and abandoned ship into a life raft as the boat foundered. All were later hoisted to safety by a U.S. Coast Guard helicopter without injury. The sinking resulted in an estimated loss of $400,000. The National Transportation Safety Board determines that the probable cause of the foundering of the wooden-hulled fishing vessel Moonlight Maid was the detachment of portside hull planking in heavy weather, which resulted in uncontrolled flooding. Contributing to the hull failure was inadequate maintenance of the aging wooden vessel. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fishing vessels KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1405.pdf UR - https://trid.trb.org/view/1309902 ER - TY - RPRT AN - 01526434 AU - National Transportation Safety Board TI - Marine Accident Brief: Engine Room Fire On Board Towing Vessel Marguerite L. Terral PY - 2014/03/10 SP - 7p AB - On June 9, 2012, about 1705 central daylight time, the uninspected towing vessel Marguerite L. Terral with six crewmembers on board was pushing 12 empty barges on the Mississippi River near Hickman, Kentucky, when the vessel's port engine caught fire. The crew tried unsuccessfully to extinguish the fire before evacuating onto one of the barges. No one was injured nor did the accident cause any pollution. The damage to the Marguerite L. Terral was estimated to be $2.6 million. The National Transportation Safety Board (NTSB) could not determine the origin of the engine room fire on board the Marguerite L. Terral. Contributing to the extent of the fire damage was the crew's failure to set fire boundaries, shut down the ventilation, and use the onboard fire suppression equipment effectively. KW - Crash investigation KW - Fire KW - Fire causes KW - Mississippi River KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1404.pdf UR - https://trid.trb.org/view/1309905 ER - TY - RPRT AN - 01526439 AU - National Transportation Safety Board TI - Pipeline Accident Report: Columbia Gas Transmission Corporation Pipeline Rupture, Sissonville, West Virginia, December 11, 2012 PY - 2014/02/19 SP - 50p AB - On December 11, 2012, at 12:41 p.m. eastern standard time, a buried 20-inch-diameter interstate natural gas transmission pipeline, owned and operated by Columbia Gas Transmission Corporation, ruptured in a sparsely populated area, about 106 feet west of Interstate 77 near Route 21 and Derricks Creek Road, in Sissonville, West Virginia. About 20 feet of pipe was separated and ejected from the underground pipeline and landed more than 40 feet from its original location. The escaping high-pressure natural gas ignited immediately. An area of fire damage about 820 feet wide extended nearly 1,100 feet along the pipeline right-of-way. Three houses were destroyed by the fire, and several other houses were damaged. There were no fatalities or serious injuries. About 76 million standard cubic feet of natural gas was released and burned. Columbia Gas Transmission Corporation reported the cost of pipeline repair was $2.9 million, the cost of system upgrades to accommodate in-line inspection was $5.5 million, and the cost of gas loss was $285,000. Major safety issues identified in this investigation were external corrosion mitigation of the ruptured pipeline, supervisory control and data acquisition alert setpoint configuration, use of automatic shutoff valves and remote control valves to improve isolation of high-pressure pipelines, and exclusion of pipelines in the vicinity of highways from integrity management regulation. The National Transportation Safety Board makes safety recommendations to Columbia Gas Transmission Corporation and the Pipeline and Hazardous Materials Safety Administration. KW - Corrosion KW - Costs KW - Fires KW - Natural gas pipelines KW - Pipeline safety KW - Recommendations KW - West Virginia UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR1401.pdf UR - https://trid.trb.org/view/1309907 ER - TY - RPRT AN - 01514423 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Tall Ship Bounty PY - 2014/02/06 SP - 16p AB - On October 29, 2012, the tall ship Bounty sank off Cape Hatteras, North Carolina, while attempting to transit through the forecasted path of Hurricane Sandy. Three of the 16 people on board were seriously injured, one crewmember died, and the captain was never found. The vessel's estimated value was $4 million. The National Transportation Safety Board determines that the probable cause of the sinking of tall ship Bounty was the captain's reckless decision to sail the vessel into the well forecasted path of Hurricane Sandy, which subjected the aging vessel and the inexperienced crew to conditions from which the vessel could not recover. Contributing to the sinking was the lack of effective safety oversight by the vessel organization. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Hurricane Sandy, 2012 KW - Hurricanes KW - Injuries KW - Sinking (Maritime crashes) KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1403.pdf UR - https://trid.trb.org/view/1298614 ER - TY - RPRT AN - 01506774 AU - National Transportation Safety Board TI - Marine Accident Brief: Bollard Failure Causing Breakaway of Cruise Ship Carnival Triumph from its Moorings, and Subsequent Collision with Dredge Wheeler and Towing Vessel Noon Wednesday PY - 2014/01/23 SP - 8p AB - On April 3, 2013, about 1328 local time, the cruise ship Carnival Triumph was moored and undergoing repairs at the BAE Systems shipyard in Mobile, Alabama, when the Port of Mobile experienced a period of high wind gusts. The vessel broke free from its moorings and drifted across the Mobile River, where it collided with the moored dredge Wheeler. A responding towing vessel, Noon Wednesday, became pinned between the cruise ship and the dredge. One shipyard employee died in the accident; another was injured. The total damage amount was estimated to be more than $2.9 million. The National Transportation Safety Board determines that the probable cause of the breakaway of the Carnival Triumph from its moorings and the subsequent collision with the dredge Wheeler and the towing vessel Noon Wednesday was the successive failure of multiple mooring bollards, which were known by BAE Systems to be in poor condition with an undetermined mooring load capability. KW - Break-aways KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Cruise ships KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1402.pdf UR - https://trid.trb.org/view/1290789 ER - TY - RPRT AN - 01506772 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Offshore Supply Vessel Ricky B PY - 2014/01/21 SP - 5p AB - On May 30, 2013, at 0702 central daylight time, the offshore supply vessel Ricky B sank in the Gulf of Mexico about 24 nm south of Marsh Island, Louisiana, while being towed. The three crewmembers had abandoned the Ricky B earlier and boarded a good samaritan vessel, from which they were subsequently transferred to a nearby manned oil platform. No one was injured. The Ricky B was later refloated. Its damage was estimated to be $520,000. The National Transportation Safety Board determines that the probable cause of the sinking of the offshore supply vessel Ricky B was the crew's failure to adequately assess the severity of the flooding rate through the starboard shaft seal gland and take prudent action to mitigate the situation. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Sinking (Maritime crashes) KW - Supply vessels KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1401.pdf UR - https://trid.trb.org/view/1290265 ER - TY - RPRT AN - 01545302 AU - National Transportation Safety Board TI - Special Investigation Report: Organizational Factors in Metro-North Railroad Accidents PY - 2014 SP - 143p AB - During the time period between May 2013 and March 2014 the National Transportation Safety Board (NTSB) launched investigative teams to five significant accidents on the Metro-North Railroad (Metro-North): (1) the May 17, 2013, derailment and subsequent collision in Bridgeport, Connectivut; (2) the May 28, 2013, employee fatality in West Haven, Connecticut; (3) the July 18, 2013, CSX drailment on Metro-North tracks in The Bronx, New York; (4) the December 1, 2013, derailment in The Bronx, New York; and (5) the March 10, 2014, employee fatality in Manhattan, New York. In combination, these accidents resulted in 6 fatalities, 126 injuries, and more than $28 million in damages. This special investigation report discusses all five of the recent Metro-North accidents investigated by the NTSB, examines some of the common elements of these accidents, and addresses the steps that Metro-North, the Metropolitan Transit Authority (MTA), and the Federal Railroad Administration have taken as a result of these investigations. This report also highlights lessons learned and provides recommendations to Metro-North, MTA, and several other entities to improve railroad safety on Metro-North and elsewhere. KW - Connecticut KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Metro-North Railroad KW - Metropolitan Transit Authority (New York) KW - New York (New York) KW - Railroad crashes KW - Railroad safety KW - Recommendations UR - http://www.ntsb.gov/safety/safety-studies/Documents/SIR1404.pdf UR - https://trid.trb.org/view/1331883 ER - TY - RPRT AN - 01505685 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision Between Bulk Carriers Mary Ann Hudson and Star Grip PY - 2013/12/18 SP - 7p AB - On June 6, 2012, at 0530 central daylight time, the underway bulk carrier Mary Ann Hudson collided with the moored bulk carrier Star Grip while the Mary Ann Hudson was being moved from City Dock 21 to City Dock 29. No one was injured and no pollution resulted from the accident; however, both vessels sustained damage totaling more than $500,000. The National Transportation Safety Board determines that the probable cause of the collision between bulk carriers Mary Ann Hudson and Star Grip was the pilot's ineffective handling of the Mary Ann Hudson and his ineffective use of the two tugboats to maneuver the vessel around the Star Grip's crane arms, which were extending into the navigable waterway. KW - Bulk carriers KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1319.pdf UR - https://trid.trb.org/view/1285695 ER - TY - RPRT AN - 01501056 AU - National Transportation Safety Board TI - Railroad Accident Brief: Amtrak Train 350 Derailment, Niles, Michigan, October 21, 2012 PY - 2013/11/20 SP - 13p AB - On Sunday October 21, 2012, at 10:10 a.m. eastbound Amtrak (National Railroad Passenger Corporation) train 350, operating over the Amtrak Michigan Line (AML) in Niles, Michigan, entered the Niles Yard from the main track at Control Point (CP) 190 while traveling 61 mph. The train derailed about 291 feet after diverging from the main track and traveled 1,148 additional feet before coming to a stop on a yard track. The National Transportation Safety Board determines that the probable cause of the accident was the unauthorized use of a jumper wire that provided a false proceed signal with a mainline switch lined to Niles Yard. The use of the jumper wire was inconsistent with Amtrak procedures for using jumper wires to override signal and train control safety-critical circuits. Contributing to the accident was the inadequate oversight by Amtrak management to ensure proper jumper wire safeguards were employed. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Derailments KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1306.pdf UR - https://trid.trb.org/view/1278508 ER - TY - RPRT AN - 01504023 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Tanker Overseas Reymar with San Francisco-Oakland Bay Bridge PY - 2013/11/07 SP - 11p AB - On January 7, 2013, at 1118 local time, the 752 foot long tanker Overseas Reymar allided with the fendering system of the San Francisco–Oakland Bay Bridge's Echo tower. The vessel was outbound in San Francisco Bay. No one was injured and no pollution was reported. Damage to the vessel was estimated at $220,000, and the cost to repair the Echo tower's fendering system was estimated at $1.4 million. The National Transportation Safety Board determines that the probable cause of the Overseas Reymar allision with the San Francisco–Oakland Bay Bridge was the pilot's decision to alter course from the CD span to the DE span without sufficient time to avoid alliding with the bridge's Echo tower, and the master's failure to properly oversee the pilot by engaging in a phone conversation during a critical point in the transit. KW - Allisions KW - Bridges KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Marine safety KW - San Francisco (California) KW - Tankers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1318.pdf UR - https://trid.trb.org/view/1284789 ER - TY - RPRT AN - 01501400 AU - National Transportation Safety Board TI - Highway Accident Report: Highway–Railroad Grade Crossing Collision, Midland, Texas, November 15, 2012 PY - 2013/11/05 SP - 84p AB - About 4:35 p.m. on November 15, 2012, in Midland, Texas, a freight train collided with a parade float at a highway–railroad grade crossing, resulting in 4 fatalities and 12 injuries. The float consisted of a 2006 Peterbilt truck-tractor in combination with a 2005 Transcraft D-Eagle drop-deck flatbed semitrailer and was traveling south on South Garfield Street as part of a parade procession honoring US military men and women. The float, occupied by 12 veterans and their spouses, continued along South Garfield Street until it reached the intersection of West Front Avenue, where the traffic signal displayed red. Law enforcement personnel stationed to block cross traffic permitted the float and its escorts to continue across the intersection unhindered. About 80 feet south of the West Front Avenue intersection was an active highway–railroad grade crossing, and the crossing’s warning system activated as the float approached. The float continued across the railroad tracks at an estimated speed of 5 mph. A Union Pacific Railroad freight train approached the South Garfield Street crossing from the west at a speed of 62 mph. The train reached the crossing and struck the right rear of the float, causing the flatbed to rotate clockwise 122 degrees. As the flatbed rotated, it struck several occupants who were evacuating the float. It also struck a stationary 2008 Ford Crown Victoria occupied by a sheriff’s deputy. The collision did not cause the train to derail. The National Transportation Safety Board (NTSB) determines that the probable cause of this collision was the failure of the city of Midland and the parade organizer, "Show of Support, Military Hunt, Inc." (Show of Support), to identify and mitigate the risks associated with routing a parade through a highway-railroad grade crossing. Contributing to the collision was the lack of traffic signal cues to indicate to law enforcement that an approaching train had preempted the normal highway traffic signal sequence at the intersection of South Garfield Street and West Front Avenue. Further contributing to the collision was an expectancy of safety on the part of the float driver, created by the presence of law enforcement personnel as escorts and for traffic control, leading him to believe that he could turn his attention to his side-view mirrors to monitor the well-being of the parade float occupants as he negotiated a dip in the roadway on approach to the grade crossing. This investigation focused on the following safety issues: driver expectations due to a consistent law enforcement escort, lack of awareness of traffic signal preemption by law enforcement escorts, and lack of parade planning. As a result of this investigation, the NTSB makes recommendations to the Federal Highway Administration, Federal Railroad Administration, city of Midland, National League of Cities, National Association of Counties, National Association of Towns and Townships, United States Conference of Mayors, International City/County Management Association, and International Festivals and Events Association. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Highway safety KW - Railroad crashes KW - Railroad grade crossings KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1302.pdf UR - https://trid.trb.org/view/1279556 ER - TY - RPRT AN - 01499345 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Fishing Vessel Mary Kay PY - 2013/10/31 SP - 4p AB - On July 26, 2012, about 2300 Alaska daylight time, the commercial fishing vessel Mary Kay sank as a result of flooding in the starboard fish hold, the lazarette, and the engine room. The sinking took place in Dixon Entrance, near Cape Chacon, Prince of Wales Island, Alaska. The four crewmembers safely abandoned the vessel and were rescued. The National Transportation Safety Board determines that the probable cause of the sinking of the Mary Kay was the captain's failure to identify and correct the source(s) of the through hull leaks. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fishing vessels KW - Leakage KW - Sinking (Maritime crashes) KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1317.pdf UR - https://trid.trb.org/view/1277738 ER - TY - RPRT AN - 01497410 AU - National Transportation Safety Board TI - Railroad Accident Brief: Switchman Struck between Two Union Pacific Rail Cars, Mason City, Iowa, July 31, 2012 PY - 2013/10/18 SP - 10p AB - On July 31, 2012, at 2:25 a.m., a Union Pacific Railroad (UPRR) switchman was killed after being crushed between two rail cars in the Mason City, Iowa, rail yard. The switchman was assigned to yard job YMC04. He went on duty on July 30, 2012, at 10:30 p.m., along with an engineer and a footboard yardmaster. During switching operations, the switchman discovered a coupler knuckle with a missing pin. While making repairs to the coupler knuckle, he was struck and fatally injured by two rail cars that rolled into him. The National Transportation Safety Board determines that the probable cause of the accident was the switchman not ensuring the two rail cars on track 3 were properly secured before attempting to repair the coupler knuckle on rail car UTLX 203998. Contributing to the accident was the lack of a thorough job briefing by the rail yard crew, specifically a review of securement requirements, before the switchman entered the gage of the rail. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Employees KW - Fatalities KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1305.pdf UR - https://trid.trb.org/view/1266087 ER - TY - RPRT AN - 01496081 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Large Crude Oil Spill from Damaged Enbridge Energy Pipeline, Romeoville, Illinois, September 9, 2010 PY - 2013/09/30 SP - 13p AB - On September 9, 2010, at 11:30 a.m., a 34-inch-diameter pipeline (Line 6A) owned and operated by Enbridge Energy, Limited Partnership (Enbridge) leaked beneath the street pavement adjacent to 717 Parkwood Avenue in the Village of Romeoville (Romeoville), Will County, Illinois, releasing about 6,430 barrels of Saskatchewan heavy crude oil. Damages, including the cost of the environmental remediation, totaled about $46.6 million. The National Transportation Safety Board determines that the probable cause of the Enbridge Energy, Limited Partnership oil pipeline leak and crude oil release near the Des Plaines River in Romeoville, Illinois, on September 9, 2010, was erosion caused by water jet impingement from a leaking 6-inch diameter water pipe 5 inches below the oil pipeline. Contributing to the accident was the interruption of the cathodic protection currents by the close proximity of the improperly installed water pipe. KW - Crash analysis KW - Crash causes KW - Crash characteristics KW - Crude oil KW - Oil spills KW - Pipeline accidents KW - Pipeline safety KW - Pipelines UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB1303.pdf UR - https://trid.trb.org/view/1265908 ER - TY - RPRT AN - 01495168 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Southwest Airlines, Flight 812, Yuma, Arizona, April 1, 2011 PY - 2013/09/24 SP - 15p AB - On April 1, 2011, about 1558 mountain standard time (MST), a Boeing 737-3H4, N632SW, operating as Southwest Airlines flight 812 experienced a rapid decompression while climbing through flight level 340. The flight crew conducted an emergency descent and diverted to Yuma International Airport (NYL), Yuma, Arizona. Of the 5 crewmembers and 117 passengers on board, one crewmember and one nonrevenue off-duty airline employee passenger sustained minor injuries. The airplane sustained substantial damage; postaccident inspection revealed that a section of fuselage skin about 60 inches long by 8 inches wide had fractured and flapped open on the upper left side above the wing. The flight was conducted under the provisions of 14 Code of Federal Regulations (CFR) Part 121 as a regularly scheduled domestic passenger flight from Phoenix Sky Harbor International Airport, Phoenix, Arizona, to Sacramento International Airport, Sacramento, California. According to the flight crew and recorded data, the takeoff and initial climb were normal. At 1558:05, an unidentified sound was recorded on the cockpit area microphone. About 2 seconds later, the captain announced that the airplane had lost cabin pressurization and called for oxygen masks on; sounds consistent with increased wind noise were heard on the cockpit voice recording. The captain declared an emergency with air traffic control and requested a lower altitude. The air traffic controller provided lower altitude clearances, and the flight crew descended the airplane to 11,000 feet within 5 minutes. Cabin oxygen masks deployed, and about 1605, the cabin crew began relaying condition reports to the flight crew describing a 2-foot hole in the fuselage and one broken-nose injury of a cabin crewmember. The airplane was cleared for further descent to 9,000 feet, and the captain requested radar vectors to the nearest suitable airport (NYL). The airplane landed about 1629 on runway 21R at NYL without further incident. The passengers deplaned via airstairs. The National Transportation Safety Board determines that the probable cause of this accident was the improper installation of the fuselage crown skin panel at the S-4L lap joint during the manufacturing process, which resulted in multiple site damage fatigue cracking and eventual failure of the lower skin panel. Contributing to the injuries was flight attendant A's incorrect assessment of his time of useful consciousness, which led to his failure to follow procedures requiring immediate donning of an oxygen mask when cabin pressure is lost. KW - Air transportation crashes KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Descent KW - Emergency maneuvers KW - Fatigue cracking KW - Injuries KW - Southwest Airlines UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB1302.pdf UR - https://trid.trb.org/view/1264107 ER - TY - RPRT AN - 01493490 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Enterprise Products Natural Gas Pipeline Excavation Damage, Rupture, and Fire, Cleburne, Texas, June 7, 2010 PY - 2013/09/09 SP - 10p AB - On June 7, 2010, at 2:40 p.m., a truck-mounted power auger (auger truck) operated by C&H Power Line Construction (C&H) struck and punctured a 36-inch-diameter natural gas transmission pipeline operated by Enterprise Products Operating, LLC (Enterprise). C&H, a contractor working for Brazos Electric (Brazos), was using the auger truck to dig holes for the installation of new electric service utility poles. The accident occurred about 45 miles southwest of Fort Worth, Texas, near the town of Cleburne. The natural gas ignited and killed the auger operator and burned six workers, who were transported to a nearby hospital for treatment. The pipeline had a maximum allowable operating pressure (MAOP) of 1,051 pounds per square inch, gauge (psig) and was operating at 950 psig at the time of the accident. Total property damage and clean-up costs were estimated to be $1,029,000. The National Transportation Safety Board determines that the probable cause of the rupture and fire was a contractor's puncturing the unmarked, underground natural gas pipeline with a power auger. Contributing factors were the lack of permanent markers along the Enterprise Products Operating, LLC, pipeline and the failure of the Enterprise pipeline locator to locate and mark the pipeline before C&H Power Line Construction attempted to install the utility pole in the pipeline right-of-way. KW - Augers KW - Crash causes KW - Crash investigation KW - Fire causes KW - Fires KW - Natural gas pipelines KW - Pipeline safety KW - Rupture UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB1302.pdf UR - https://trid.trb.org/view/1262154 ER - TY - RPRT AN - 01499800 AU - National Transportation Safety Board TI - Railroad Accident Brief: BNSF Railway Employee Struck by Moving Railroad Equipment, Amarillo, Texas, January 9, 2012 PY - 2013/08/30 SP - 8p AB - On Monday, January 9, 2012, at 11:09 a.m. central standard time, a BNSF Railway (BNSF) welding foreman on yard track No. 1805 near Amarillo, Texas, was struck and killed by a J6 rail grinding machine. The grinding machine was operated by a Loram crew consisting of a superintendent field operations/equipment operator, a general laborer (Loram laborer), a crew chief, and a safety coordinator. At the time of the accident, the crew chief was getting parts for the equipment and was not at the accident location. A Loram general laborer said that the welding foreman had given a hand signal for a reverse-movement to the machine operator, and then the foreman walked across the north rail into the center of the track to the derail on the south rail. The foreman crouched down with his back to the grinding machine to unlock the derail and remove it from the south rail to allow the reverse movement. When the operator realized that the welding foreman was in the gage of the track, he could not stop the equipment before it struck the welding foreman. The welding foreman was part of a two-member BNSF track maintenance crew consisting of himself, who was the roadway worker in charge of the rail grinding operation at the time of the accident, and a laborer (BNSF laborer). However, the BNSF laborer had called the welding foreman earlier that day to say that he was going to arrive at the worksite late, and he was not on site at the time of the accident. The weather at the time of the accident was about 37˚F and clear. The wind direction was to the northeast and about 5 mph. The National Transportation Safety Board determines that the probable cause of the accident was the BNSF welding foreman’s entering the gage of the track in front of the moving Loram grinding machine. Contributing to the accident was Loram’s ineffective training on the operating rules governing point protection and signaling of equipment movement. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Employees KW - Fatalities KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1304.pdf UR - https://trid.trb.org/view/1278093 ER - TY - RPRT AN - 01493304 AU - National Transportation Safety Board TI - Railroad Accident Brief: Employee Struck by Moving Equipment, Amarillo, Texas, January 9, 2012 PY - 2013/08/30 SP - 8p AB - On Monday, January 9, 2012, at 11:09 a.m. central standard time, a BNSF Railway (BNSF) welding foreman on yard track No. 1805 near Amarillo, Texas, was struck and killed by a J6 rail grinding machine. The grinding machine was operated by a Loram crew consisting of a superintendent field operations/equipment operator, a general laborer (Loram laborer), a crew chief, and a safety coordinator. At the time of the accident, the crew chief was getting parts for the equipment and was not at the accident location. A Loram general laborer said that the welding foreman had given a hand signal for a reverse-movement to the machine operator, and then the foreman walked across the north rail into the center of the track to the derail on the south rail. The foreman crouched down with his back to the grinding machine to unlock the derail and remove it from the south rail to allow the reverse movement. When the operator realized that the welding foreman was in the gage of the track, he could not stop the equipment before it struck the welding foreman. The National Transportation Safety Board determines that the probable cause of the accident was the BNSF welding foreman’s entering the gage of the track in front of the moving Loram grinding machine. Contributing to the accident was Loram’s ineffective training on the operating rules governing point protection and signaling of equipment movement. KW - Amarillo (Texas) KW - BNSF Railway KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Railroad crashes KW - Railroad safety KW - Railroad yards UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1304.pdf UR - https://trid.trb.org/view/1261358 ER - TY - RPRT AN - 01493470 AU - National Transportation Safety Board TI - Railroad Accident Brief: CSX Transportation Collision, Westville, Indiana, January 6, 2012 PY - 2013/08/20 SP - 18p AB - On January 6, 2012, at 1:18 p.m., westbound CSX Transportation (CSX) freight train Q39506 struck the rear end of standing westbound CSX freight train K68303 on track 2 at milepost (MP) 224.5 near Westville, Indiana. The crew of train Q39506 had just escaped the locomotive, which had derailed on its side onto track 1, when CSX westbound freight train Q16105, operating on track 1, struck the derailed locomotive. The derailed equipment from both collisions included the last 7 cars of train K68303, both locomotives and 6 cars of train Q39506, and all 3 locomotives and 12 cars of train Q16105. Spilled diesel fuel from the locomotives caught fire. The engineer and conductor of train Q39506 were injured and transported to a local hospital. The weather was clear and 54°F at the time of the accident. The estimated damage was about $5 million. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the crew of train Q39506 to maintain vigilant attention to wayside signals, communicate effectively, avoid distractions from prohibited text messaging, and comply with the speed restrictions required by the railroad signal system. Contributing to the accident was the lack of a positive train control system that would have stopped the train and prevented the collision regardless of the crew’s inaction. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Distraction KW - Positive train control KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1303.pdf UR - https://trid.trb.org/view/1261166 ER - TY - RPRT AN - 01491456 AU - National Transportation Safety Board TI - Railroad Accident Brief: Derailment and hazardous materials release and fire, Tiskilwa, Illinois, October 7, 2011 PY - 2013/08/14 SP - 11p AB - On October 7, 2011, at 2:14 a.m. central daylight time, 26 cars in eastbound Iowa Interstate Railroad (IAIS) train RI-BI-06 derailed in Tiskilwa, Illinois. Ten of the derailed cars contained ethanol, a hazardous material; ethanol released from the damaged tank cars ignited and burned. Property damage was estimated to be $1.6 million. The engineer and the conductor were not injured. No emergency responders were injured during the fire suppression and cleanup efforts. The National Transportation Safety Board determines that the probable cause of the accident was a broken rail. Contributing to the large quantity of hazardous materials released was inadequate puncture resistance of the tank heads and shells of the DOT-111A-100W1 general service tank cars and the failure of draft sill attachments. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Derailments KW - Hazardous materials KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1302.pdf UR - https://trid.trb.org/view/1259871 ER - TY - RPRT AN - 01490003 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Pipeline rupture and gas release Near Palm City, Florida, May 4, 2009 PY - 2013/08/13 SP - 18p AB - On Monday, May 4, 2009, about 5:10 a.m. eastern daylight time, Florida Gas Transmission Company’s (FGT) line 100, an 18-inch-diameter natural gas transmission pipeline, ruptured about 6 miles south of Palm City, Florida. The rupture occurred in a sparsely populated rural area of Martin County and displaced about 106 feet of buried pipe onto the right-of-way between Interstate 95 (I - 95) and the Florida Turnpike (SR - 91). An estimated 36 million cubic feet of natural gas was released during the accident without ignition.Two parallel FGT natural gas transmission pipelines in the same right-of-way were undamaged. Three minor injuries were attributed to the rupture : two people were injured escaping from a vehicle that lost control and ran off the turnpike, and one member of the Palm Beach County Sheriff’s department walked through a dense cloud and inhaled natural gas. The rupture occurred between two automatic shutoff valves (ASV), but only one valve shut in response to the pressure drop on the pipeline. The National Transportation Safety Board determines that the probable cause of the accident was environmentally assisted cracking under a disbonded polyethylene coating that remained undetected by the integrity management program. Contributing to the accident was Florida Gas Transmission Company’s failure to include the pipe section that ruptured in the integrity management program. Contributing to the prolonged gas release was the pipeline controller’s inability to detect the rupture because of Supervisory Control and Data Acquisition (SCADA) system limitations and the configuration of the pipeline. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Natural gas pipelines KW - Pipeline accidents KW - Pipeline safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB1301.pdf UR - https://trid.trb.org/view/1259531 ER - TY - RPRT AN - 01493472 AU - National Transportation Safety Board TI - Highway Accident Report: School Bus and Truck Collision at Intersection Near Chesterfield, New Jersey, February 16, 2012 PY - 2013/07/23 SP - 113p AB - On February 16, 2012, about 8:15 a.m., near Chesterfield, New Jersey, a Garden State Transport Corporation 2012 IC Bus, LLC, school bus was transporting 25 students to Chesterfield Elementary School. The bus was traveling north on Burlington County Road (BCR) 660, while a Herman’s Trucking Inc. 2004 Mack roll-off truck with a fully loaded dump container was traveling east on BCR 528, approaching the intersection. The bus driver had stopped at the flashing red traffic beacon and STOP sign. As the bus pulled away from the white stop line and entered the intersection, it failed to yield to the truck and was struck behind the left rear axle. The bus rotated nearly 180 degrees and subsequently struck a traffic beacon support pole. One bus passenger was killed. Five bus passengers sustained serious injuries, 10 passengers and the bus driver received minor injuries, and nine passengers and the truck driver were uninjured. The National Transportation Safety Board determines that the probable cause of the Chesterfield, New Jersey, crash was the school bus driver's failure to observe the Mack roll-off truck, which was approaching the intersection within a hazardous proximity. Contributing to the school bus driver's reduced vigilance were cognitive decrements due to fatigue as a result of acute sleep loss, chronic sleep debt, and poor sleep quality, in combination with, and exacerbated by, sedative side effects from his use of prescription medications. Contributing to the severity of the crash was the truck driver's operation of his vehicle in excess of the posted speed limit, in addition to his failure to ensure that the weight of the vehicle was within allowable operating restrictions. Further contributing to the severity of the crash were the defective brakes on the truck and its overweight condition due to poor vehicle oversight by Herman's Trucking, along with improper installation of the lift axle brake system by the final stage manufacturer—all of which degraded the truck's braking performance. Contributing to the severity of passenger injuries were the nonuse or misuse of school bus passenger lap belts; the lack of passenger protection from interior sidewalls, sidewall components, and seat frames; and the high lateral and rotational forces in the back portion of the bus. Major safety issues identified in this investigation were school bus driver fatigue, sedating prescription medications, medical conditions, and commercial driver’s license medical examinations; truck driver speed, oversight of overweight commercial vehicles, brake maintenance, and final stage manufacturing air brake system installation; connected vehicle technology; and school bus occupant injuries and school bus crashworthiness. The National Transportation Safety Board makes recommendations to the Federal Motor Carrier Safety Administration; National Highway Traffic Safety Administration; states of California, Florida, Louisiana, New Jersey, New York, and Texas; National Truck Equipment Association; National Association of State Directors of Pupil Transportation Services; National Association for Pupil Transportation; National School Transportation Association; School Bus Manufacturers Technical Council; National Safety Council, School Transportation Section; and Herman’s Trucking Inc. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - School bus drivers KW - School bus safety KW - Truck crashes KW - Truck drivers KW - Trucking safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1301.pdf UR - https://trid.trb.org/view/1261979 ER - TY - RPRT AN - 01489435 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding and Loss of the F/V Chevelle, North jetty of Yaquina Bay entrance, Newport, Oregon, March 10, 2012 PY - 2013/07/18 SP - 6p AB - The fishing vessel Chevelle was returning to its home port of Newport, Oregon, when a series of large breaking waves on its stern resulted in a loss of maneuverability and grounding on the Yaquina Bay entrance north jetty on March 10, 2012. The crew was hoisted to safety by a US Coast Guard helicopter before the vessel broke apart and sank more than a day later, resulting in an estimated loss of $625,000. No one was injured. The National Transportation Safety Board determines that the probable cause of the grounding and subsequent loss of the Chevelle as it crossed the Yaquina Bay bar was the master's loss of control of the fishing vessel after a series of breaking waves on the stern heeled the vessel to a severe degree from which it did not recover. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fishing vessels KW - Groundings (Maritime crashes) KW - Marine safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1315.pdf UR - https://trid.trb.org/view/1257556 ER - TY - RPRT AN - 01493484 AU - National Transportation Safety Board TI - Marine Accident Brief: Dockside Capsizing and Sinking of Towing Vessel Invader and Dry Dock #3, Vigor Industrial Shipyard, Port of Everett, Washington, March 18, 2012 PY - 2013/07/16 SP - 5p AB - On March 18, 2012, about 0630 Pacific standard time, the uninspected towing vessel Invader capsized in Port of Everett, Washington, after the floating Dry Dock #3 on which the vessel was positioned flooded and began listing. Both the Invader and Dry Dock #3 intitially sank, but were later refloated. The National Transportation Safety Board determines that the probable cause of the capsizing and sinking of the towing vessel Invader and Dry Dock #3 was Vigor Industrial Shipyard's lack of operational oversight in ensuring that the discharge valves and manholes were closed after use, and its failure to continuously monitor the condition of the dry dock. KW - Capsizing KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Drydocks KW - Maritime safety KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1316.pdf UR - https://trid.trb.org/view/1261167 ER - TY - RPRT AN - 01489407 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire On Board and Sinking of Liftboat Mako, Atlantic Ocean, Gulf of Guinea, 6 miles off the coast of Nigeria, January 16, 2012 PY - 2013/07/16 SP - 5p AB - About 0503 on January 16, 2012, the US liftboat Mako caught fire while supporting oil drilling operations about 6 miles off the coast of Nigeria, Africa. No one on board was injured, but the Mako was a total loss in the accident. The National Transportation Safety Board determines that the probable cause of the fire on board and sinking of the liftboat Mako was a blow-out of the well-head under the adjacent jack-up drilling rig KS Endeavor, which resulted in an uncontrollable gas fire that rapidly spread to the liftboat. KW - Crash characteristics KW - Crash investigation KW - Fire causes KW - Fires KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1314.pdf UR - https://trid.trb.org/view/1257557 ER - TY - RPRT AN - 01486899 AU - National Transportation Safety Board TI - Fire on Board Passenger Vessel Safari Spirit PY - 2013/07/03 SP - 5p AB - A fire broke out on the aft deck on board the passenger vessel Safari Spirit while the vessel was docked at Pier 9 of Fisherman's Terminal in the Ballard area of Seattle, Washington, on April 27, 2012, about 0100 local time. The vessel was off charter but soon to start its seasonal cruising schedule in Alaska. The National Transportation Safety Board determines that the probable cause of the fire aboard the passenger vessel Safari Spirit was spontaneous combustion due to the self-heating of used rags on the aft deck near stored flammable materials. KW - Crash characteristics KW - Crash investigation KW - Fire causes KW - Fires KW - Marine safety KW - Passenger ships KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1312.pdf UR - https://trid.trb.org/view/1255494 ER - TY - RPRT AN - 01490008 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Oil Tanker FR8 Pride with MODU Rowan EXL I PY - 2013/06/27 SP - 7p AB - On May 2, 2012, at 0718, the oil tanker FR 8 Pride collided with the mobile offshore drilling unit (MODU) Rowan EXL I in Aransas Pass, Corpus Christi, Texas. No one was injured in the collision, but the two vessels sustained an estimated $16–17 million in damage. The National Transportation Safety Board determines that the probable cause of the collision of oil tanker FR 8 Pride with MODU Rowan EXL I was the failure of the FR 8 Pride’s main propulsion engine, which resulted in reduced maneuverability of the ship. KW - Crash causes KW - Crash investigation KW - Marine safety KW - Offshore drilling platforms KW - Oil tankers KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1313.pdf UR - https://trid.trb.org/view/1259157 ER - TY - RPRT AN - 01490007 AU - National Transportation Safety Board TI - Railroad Accident Report: Head-On Collision of Two Union Pacific Railroad Freight Trains Near Goodwell, Oklahoma, June 24, 2012 PY - 2013/06/18 SP - 65p AB - On Sunday, June 24, 2012, at 10:02 a.m. central daylight time, eastbound Union Pacific Railroad (UP) freight train ZLAAH 22 and westbound UP freight train AAMMLX 22 collided head-on while operating on straight track on the UP Pratt subdivision near Goodwell, Oklahoma. The collision derailed 3 locomotives and 24 cars of the eastbound train and 2 locomotives and 8 cars of the westbound train. The engineer and the conductor of the eastbound train and the engineer of the westbound train were killed. The conductor of the westbound train jumped to safety. During the collision and derailment, several fuel tanks from the derailed locomotives ruptured, releasing diesel fuel that ignited and burned. Damage was estimated at $14.8 million. Safety issues identified in this investigation were the actions and responsibilities of the train crews, the medical examination process for railroad engineer certification, the survivability of event recorder data, and the need for implementation of positive train control. The National Transportation Safety Board makes safety recommendations to the Federal Railroad Administration, the Brotherhood of Locomotive Engineers and Trainmen, the United Transportation Union, all Class I Railroads, the Union Pacific Railroad, and all railroads subject to the positive train control provisions of the Rail Safety Improvement Act of 2008. The National Transportation Safety Board also reiterates recommendations to the Federal Railroad Administration and the Association of American Railroads and reclassifies three recommendations to the Federal Railroad Administration. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Frontal crashes KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1302.pdf UR - https://trid.trb.org/view/1259491 ER - TY - RPRT AN - 01526416 AU - National Transportation Safety Board TI - Crashes Involving Single-Unit Trucks that Resulted in Injuries and Deaths PY - 2013/06/17/Safety Study SP - 117p AB - There are 8.22 million single-unit trucks registered in the United States, which travel more than 110.7 billion miles each year. Although single-unit trucks comprise three percent of registered motor vehicles and four percent of miles traveled, they are involved in nine percent of fatalities among passenger vehicle occupants in multivehicle crashes. Crashes involving single-unit trucks and passenger vehicles pose a hazard to passenger vehicle occupants due to the differences in weight, bumper height, and vehicle stiffness. The National Transportation Safety Board (NTSB) undertook this study because of concerns about the safety record of single-unit trucks and an interest in identifying countermeasures to address the risks posed by these vehicles. One of the concerns is that single-unit trucks are excluded from some safety rules applicable to tractor-trailers. This study used a variety of data sources, including state records of police and hospital reports, federal databases, and case reviews of selected single-unit truck crashes. Risks were compared between single-unit trucks and tractor-trailers. The study found that the adverse effects of single-unit truck crashes have been underestimated in the past because these trucks are frequently misclassified and thus undercounted in federal and state databases (approximately 20 percent in the case of fatalities). There are substantial societal impacts resulting from single-unit truck crashes, including deaths, non-fatal injuries, hospitalizations, and hospital costs. Areas identified for safety improvements include the need to (1) enhance the ability of drivers of single-unit trucks to detect vulnerable road users such as pedestrians and cyclists, (2) prevent passenger vehicles from underriding the rears and sides of single-unit trucks, (3) improve conspicuity of single-unit trucks, (4) improve federal and state databases on large truck crashes, (5) continue the functions of databases vital for accurate fatality data or that link hospital data with police reports, (6) examine the frequency and consequences of single-unit truck drivers operating with an invalid license, and (7) research the potential benefits of expanding the commercial driver’s licensure requirement to lower weight classes. KW - Countermeasures KW - Crash data KW - Crash injuries KW - Fatalities KW - Multiple vehicle crashes KW - Passenger vehicles KW - Truck crashes KW - Truck drivers KW - Trucks KW - United States UR - http://www.ntsb.gov/safety/safety-studies/Documents/SS1301.pdf UR - https://trid.trb.org/view/1309825 ER - TY - RPRT AN - 01485143 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Fishing Vessel Viking II PY - 2013/06/14 SP - 4p AB - About 0900 on October 7, 2012, the 64-foot-long fishing vessel Viking II sank about 75 nautical miles off Cape May, New Jersey, following several hours of uncontrollable flooding in the engine room. The three crewmembers on board (a captain and his two sons) were rescued unharmed. The National Transportation Safety Board determines that the probable cause of the sinking of fishing vessel Viking II was uncontrolled flooding of the engine room from an undermined source. KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Floods KW - Marine safety KW - Water transportation crashes UR - https://trid.trb.org/view/1253774 ER - TY - RPRT AN - 01485163 AU - National Transportation Safety Board TI - Marine Accident Brief: Engine Room Fire On Board Towing Vessel Patrice McAllister PY - 2013/06/06 SP - 9p AB - On March 27, 2012, at 0229 eastern daylight time, the uninspected towing vessel (UTV) Patrice McAllister, with six crewmembers onboard, experienced an engine room fire. At the time, the vessel was transiting east on Lake Ontario en route from Toledo, Ohio, to Staten Island, New York. The crew released CO2 from the vessel's fire suppression system into the engine room and extinguished the fire; however, the fire later reflashed and burned out of control. The vessel's chief engineer was fatally injured, and the five remaining crewmembers suffered minor injuries. The National Transportation Safety Board determines that the probable cause of the engine room fire on board the Patrice McAllister was the ignition of lubricating oil that sprayed from a fatigue-fractured fitting on the portside main engine's pre-lubrication oil pump onto the hot surface of the portside main engine's exhaust manifold. Contributing to the extent of the fire damage was the crewmembers' compromise of the fire boundaries when they prematurely began de-smoking the vessel's superstructure; the inability to completely secure the engine room's fire boundaries; and the abundance of flammable material throughout the vessel. KW - Crash characteristics KW - Crash investigation KW - Fire causes KW - Fires KW - Marine safety KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1310.pdf UR - https://trid.trb.org/view/1253775 ER - TY - RPRT AN - 01483832 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Canadian Bulk Carrier John D. Leitch with Law Enforcement Vessel PY - 2013/05/28 SP - 6p AB - The730-foot-long Canadian-flag bulk carrier John D. Leitch, loaded with furnace coke, was outbound in the Black River at Lorain, Ohio, when the vessel collided with a 35-footfiberglass-reinforced plastic law enforcement vessel and piling structure about 0912 on October 3, 2012. The National Transportation Safety Board determines that the probable cause of the allision was the failure of the master of the John D. Leitch to properly account for bank effect while maneuvering in the confined waters of the Black River. KW - Allisions KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1309.pdf UR - https://trid.trb.org/view/1252431 ER - TY - RPRT AN - 01482294 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire on Board Uninspected Towing Vessel Ivory Coast PY - 2013/05/16 SP - 4p AB - The US uninspected towing vessel Ivory Coast was moored at General Ship Repair (GSR) in Baltimore's Northwest Harbor while undergoing cutting and welding—or "hot work"—on the starboard side hull plating in the engine room when a fire ignited and spread to the main deck galley on October 10, 2011. Damage to the engine room, associated machinery, and galley on the main deck was extensive, with repairs estimated to cost over $1million. The National Transportation Safety Board determines the probable cause of the fire on board the uninspected towing vessel Ivory Coast was sparks from welding and cutting repair work conducted with an oxygen-acetylene torch igniting unprotected combustible material in the engine room. KW - Baltimore Harbor KW - Engine rooms KW - Fire KW - Fire causes KW - Repairing KW - Uninspected towing vessels KW - Water transportation crashes KW - Welding UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1306.pdf UR - https://trid.trb.org/view/1250801 ER - TY - RPRT AN - 01485142 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of the Cargo Vessel M/V Delta Mariner with Eggner's Ferry Bridge, Tennessee River Near Aurora, Kentucky, January 26, 2012 PY - 2013/05/14 SP - 55p AB - This report discusses the allision of the cargo vessel Delta Mariner with Eggner’s Ferry Bridge at mile marker 41.7 of the Tennessee River near Aurora, Kentucky, on January 26, 2012. No injuries were reported on the ship or on the bridge. Estimated costs to repair the vessel and remove bridge debris from its bow were $2,583,750. The Kentucky Transportation Cabinet (KYTC) reported total costs of more than $7 million for bridge repair and related items. Safety issues identified in this report include bridge team performance on board the Delta Mariner and oversight by the ship’s owner; the company’s implementation of its safety management system and oversight of vessel operations; bridge lighting maintenance by KYTC; and the US Coast Guard’s oversight of bridge navigation lighting and process for disseminating warnings to mariners. The National Transportation Safety Board issued recommendations to KYTC concerning effective bridge lighting and maintenance on July 25, 2012. This report includes recommendations to the Coast Guard regarding the maintenance of bridge navigation lighting and dissemination of broadcast notices to mariners; to the Federal Highway Administration with respect to state transportation department responsibilities regarding bridge navigation lighting; and to Foss Maritime Company, owner of the Delta Mariner, concerning passage planning, the expertise required of contract pilots, and clarification of their duties and responsibilities. The National Transportation Safety Board determines the probable cause of the allision of the M/V Delta Mariner with Eggner's Ferry Bridge was the bridge team's exclusive reliance on the contract pilot's incorrect navigational direction as the vessel approached the bridge and their failure to use all available navigation tools to verify the safety of the vessel';s course. Contributing to the accident was Foss Maritime Company's failure to exercise effective safety oversight of the Delta Mariner's operations and the failure of the Kentucky Transportation Cabinet to effectively maintain bridge navigation lighting. KW - Allisions KW - Bridges KW - Cargo ships KW - Crash causes KW - Crash investigation KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1302.pdf UR - https://trid.trb.org/view/1253776 ER - TY - RPRT AN - 01484270 AU - National Transportation Safety Board TI - Marine Accident Report: Allison of the Cargo Vessel M/V Delta Mariner with Eggner's Ferry Bridge, Tennessee River Near Aurora, Kentucky, January 26, 2012 PY - 2013/05/14 SP - 55p AB - This report discusses the allision of the cargo vessel Delta Mariner with Eggner’s Ferry Bridge at mile marker 41.7 of the Tennessee River near Aurora, Kentucky, on January 26, 2012. No injuries were reported on the ship or on the bridge. Estimated costs to repair the vessel and remove bridge debris from its bow were $2,583,750. The Kentucky Transportation Cabinet (KYTC) reported total costs of more than $7 million for bridge repair and related items. Safety issues identified in this report include bridge team performance on board the Delta Mariner and oversight by the ship’s owner; the company’s implementation of its safety management system and oversight of vessel operations; bridge lighting maintenance by KYTC; and the US Coast Guard’s oversight of bridge navigation lighting and process for disseminating warnings to mariners. The National Transportation Safety Board issued recommendations to KYTC concerning effective bridge lighting and maintenance on July 25, 2012. This report includes recommendations to the Coast Guard regarding the maintenance of bridge navigation lighting and dissemination of broadcast notices to mariners; to the Federal Highway Administration with respect to state transportation department responsibilities regarding bridge navigation lighting; and to Foss Maritime Company, owner of the Delta Mariner, concerning passage planning, the expertise required of contract pilots, and clarification of their duties and responsibilities. The National Transportation Safety Board determines the probable cause of the allision of the M/V Delta Mariner with Eggner’s Ferry Bridge was the bridge team’s exclusive reliance on the contract pilot’s incorrect navigational direction as the vessel approached the bridge and their failure to use all available navigation tools to verify the safety of the vessel’s course. Contributing to the accident was Foss Maritime Company’s failure to exercise effective safety oversight of the Delta Mariner’s operations and the failure of the Kentucky Transportation Cabinet to effectively maintain bridge navigation lighting. KW - Allisions KW - Cargo ships KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1302.pdf UR - https://trid.trb.org/view/1252720 ER - TY - RPRT AN - 01481379 AU - National Transportation Safety Board TI - Reaching Zero: Actions to Eliminate Alcohol-Impaired Driving PY - 2013/05/14/Safety Report SP - 100p AB - This safety report represents the culmination of a year-long National Transportation Safety Board (NTSB) effort focused on the problem of substance-impaired driving. The report addresses the necessity of providing all the following elements to achieve meaningful reductions in alcohol-impaired driving crashes: stronger laws, improved enforcement strategies, innovative adjudication programs, and accelerated development of new in-vehicle alcohol detection technologies. Moreover, the report recognizes the need for states to identify specific and measurable goals for reducing impaired driving fatalities and injuries, and to evaluate the effectiveness of implemented countermeasures on an ongoing basis. Specifically, in the report, the NTSB makes safety recommendations in the following safety issue areas: reducing the per se blood alcohol concentration limit for all drivers; conducting high-visibility enforcement of impaired driving laws and incorporating passive alcohol sensing technology into enforcement efforts; expanding the use of in-vehicle devices to prevent operation by an impaired driver; using driving while intoxicated (DWI) courts and other programs to reduce recidivism by repeat DWI offenders; and establishing measurable goals for reducing impaired driving and tracking progress toward those goals. KW - Adjudication KW - Alcohol ignition interlock devices KW - Blood alcohol levels KW - Countermeasures KW - Courts KW - Drunk drivers KW - Drunk driving KW - Laws and legislation KW - Recidivism KW - Strategic planning KW - Traffic law enforcement UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR1301.pdf UR - https://trid.trb.org/view/1250391 ER - TY - RPRT AN - 01481526 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire Aboard Vehicle Carrier M/V Alliance Norfolk PY - 2013/05/10 SP - 5p AB - On the morning of March 10, 2012, while transiting between Malta and Sicily, Italy, in the Mediterranean Sea, the M/V Alliance Norfolk, a roll on/roll off vehicle carrier, encountered rough weather and heavy seas resulting in damage to its cargo and a subsequent fire on a cargo deck. The fire was extinguished at sea, but 2 days later while in port, the damaged cargo deck was ventilated, and the fire reflashed , causing further damage to the vessel and its cargo. The National Transportation Safety Board determines the probable cause of the fire on board the M/V Alliance Norfolk was ignition of flammable material by an undetermined ignition source on deck 5 due to shifting cargo while the vessel was rolling in heavy seas after losing power. Contributing to the severity of the damage was the reflash of the smoldering fire when the vessel was in port. KW - Crash causes KW - Crash investigation KW - Fire causes KW - Fires KW - Freight transportation KW - Marine safety KW - Roll on roll off ships UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1305.pdf UR - https://trid.trb.org/view/1250349 ER - TY - RPRT AN - 01483190 AU - National Transportation Safety Board TI - Marine Accident Report: Personnel Abandonment of Weather-Damaged US Liftboat Trinity II, with Loss of Life, Bay of Campeche, Gulf of Mexico, September 8, 2011 PY - 2013/04/09 SP - 56p AB - This report discusses the September 8, 2011, accident involving the US liftboat Trinity II. Ten persons were on board. Because of severe weather and boarding seas associated with Hurricane Nate, the elevated liftboat’s stern jacking leg failed and the onboard personnel abandoned the vessel. Four of them died. As a result of this accident investigation, the National Transportation Safety Board makes new safety recommendations to the US Coast Guard, the US Department of State, Trinity Liftboats, Geokinetics, and the Offshore Marine Service Association. The National Transportation Safety Board (NTSB) determines that the probable cause of the accident was the failure of Trinity Liftboats (the vessel owner/operator) and Geokinetics (the chartering organization) to adequately plan for the risks associated with a rapidly developing surface low pressure weather system, which ultimately subjected the elevated liftboat to hurricane-force conditions, causing the stern jacking leg to fail and the onboard personnel to abandon the vessel. Contributing to the injuries and fatalities was the failure of the Trinity II crewmembers to make effective use of the vessel’s available lifesaving equipment, resulting in the personnel’s prolonged exposure to the elements while awaiting rescue. Safety issues identified in this accident include inadequate weather preparedness and improper use of available lifesaving equipment. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1301.pdf UR - https://trid.trb.org/view/1251775 ER - TY - RPRT AN - 01481535 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash Following Loss of Engine Power Due to Fuel Exhaustion Air Methods Corporation, Eurocopter AS350 B2, N352LN, Near Mosby, Missouri, August 26, 2011 PY - 2013/04/09 SP - 66p AB - This report discusses the August 26, 2011, accident involving a Eurocopter AS350 B2 helicopter, N352LN, which crashed following a loss of engine power as a result of fuel exhaustion near the Midwest National Air Center, Mosby, Missouri. The pilot, flight nurse, flight paramedic, and patient were killed, and the helicopter was substantially damaged by impact forces. Safety issues identified in this accident include the following: distraction due to nonoperational use of portable electronic devices during flight and ground operations; the lack of Air Methods Operational Control Center involvement in decision-making; inadequate guidance on autorotation entry procedures; the need for simulator training of helicopter emergency medical services pilots; and the lack of a flight recorder. As a result of this investigation, the National Transportation Safety Board makes safety recommendations to the Federal Aviation Administration (FAA) and Air Methods Corporation, reiterates previous recommendations to the FAA, and reiterates and reclassifies a previous recommendation to the FAA. KW - Air ambulances KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Helicopters UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1302.pdf UR - https://trid.trb.org/view/1249874 ER - TY - RPRT AN - 01476659 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Two Canadian National Railway Freight Trains near Two Harbors, Minnesota September 30, 2010 PY - 2013/02/12 SP - 60p AB - On September 30, 2010, about 4:05 p.m. central daylight time, a southbound Canadian National Railway freight train collided head on with a northbound Canadian National Railway freight train near Two Harbors, Minnesota. The collision occurred near milepost 13.5 on Canadian National Railway’s Iron Range Subdivision. The trains were operating in nonsignaled territory. The northbound train had 118 empty iron ore railcars and had authority to operate on the single main track. The southbound train had 116 railcars loaded with iron ore and did not have authority to operate on the single main track. The crew of the southbound train entered the main track after failing to properly execute an after-arrival track authority. A total of three locomotives and 14 railcars derailed. All five crewmembers on the two trains were injured and transported to hospitals. Four crewmembers were treated and released; one crewmember remained hospitalized for further treatment. Canadian National Railway estimated damages at $8.1 million. As a result of its investigation of this accident, the National Transportation Safety Board (NTSB) makes recommendations to the Federal Railroad Administration, Canadian National Railway, the Brotherhood of Locomotive Engineers and Trainmen, the United Transportation Union, Canadian Pacific Railway Limited, Kansas City Southern Railway Company, Norfolk Southern Railroad, and Union Pacific Railroad. The NTSB also reiterates previous recommendations to the Federal Railroad Administration, BNSF Railway, and the American Short Line and Regional Railroad Association. The NTSB also reiterates and reclassifies recommendations to the Federal Railroad Administration. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Crashes KW - Freight trains KW - Minnesota KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1301.pdf UR - https://trid.trb.org/view/1246499 ER - TY - RPRT AN - 01476657 AU - National Transportation Safety Board TI - Marine Accident Brief: Determination of Probable Cause: Engine Room Fire and Eventual Flooding and Sinking of Fishing Vessel Lucky Diamond PY - 2013/02/01 SP - 3p AB - The fishing vessel Lucky Diamond caught fire and burned for several hours before sinking in 40 feet of water about 2200 on May 10, 2012. The master of the vessel suffered first-degree burns to his face and eyes, and the remaining three crewmembers were lost and are presumed dead. The National Transportation Safety Board determines that the probable cause of the loss of the uninspected fishing vessel Lucky Diamond was a fire of unknown origin in the engine room followed by down-flooding of the interior compartments and eventual sinking of the vessel. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fires KW - Fishing vessels KW - Injuries KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1303.pdf UR - https://trid.trb.org/view/1246497 ER - TY - RPRT AN - 01476658 AU - National Transportation Safety Board TI - Aircraft Accident Report: Loss of Control Sundance Helicopters, Inc. Eurocopter AS350-B2, N37SH, Near Las Vegas, Nevada, December 7, 2011 PY - 2013/01/29 SP - 53p AB - This report discusses the December 7, 2011, accident involving a Sundance Helicopters, Inc., Eurocopter AS350-B2 helicopter, N37SH, operating as a “Twilight tour” sightseeing trip, which crashed in mountainous terrain about 14 miles east of Las Vegas, Nevada. The pilot and four passengers were killed, and the helicopter was destroyed by impact forces and postimpact fire. The safety issues identified in this accident are the improper reuse of degraded self-locking nuts, maintenance personnel fatigue, the need for work cards with delineated steps, and the lack of human factors training for maintenance personnel. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Helicopters KW - Las Vegas (Nevada) KW - Loss of control UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1301.pdf UR - https://trid.trb.org/view/1246498 ER - TY - RPRT AN - 01472463 AU - National Transportation Safety Board TI - Railroad Accident Brief: CSX Transportation freight train was traveling about 48 mph on a single main track when it struck the rear of northbound CSX freight train PY - 2013/01/29 SP - 7p AB - On May 24, 2011, about 3:35 a.m. eastern daylight time, northbound CSX Transportation (CSX) freight train Q19423 (striking train) was traveling about 48 mph on a single main track when it struck the rear of northbound CSX freight train Q61822 (struck train), which was stopped on the track near Mineral Springs, North Carolina. The struck train was stopped at a red signal, located at milepost (MP) 313.7 near Mineral Springs, waiting for another northbound train (train 616) on the track ahead to proceed. The accident occurred at MP 314 on the CSX Florence Division, Monroe Subdivision. In the accident, two locomotives and the first nine cars of the striking train and the last four cars of the struck train derailed. The two crewmembers of the striking train were fatally injured; the two crewmembers of the struck train were treated for minor injuries. Property damage was estimated to be $1.6 million. Before the accident, the striking train had passed a yellow (approach) signal at the north end of control point (CP) Waxhaw. The CSX operating rules for an approach signal indication require train crews to proceed but be prepared to stop at the next signal while not exceeding 30 mph. However, the train's event recorder data indicated that the striking train had been traveling at speeds as great as 35 mph before reaching the signal at MP 316. This speed was noncompliant with the CSX operating rules. During postaccident inspections, NTSB investigators found that all signal units, switches, and signal cases between the north end of CP Waxhaw and the south end of CP Monroe were locked and secured with no indications of tampering or vandalism. Testing of the signal at MP 316 revealed that the red aspect of the signal was not illuminated. Further testing found that the signal lamp for the red aspect was burned out. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the striking train crew to comply with the speed restriction required when they encountered a dark signal. Contributing to the accident was the lack of a positive train control system that could have prevented the accident. KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Railroad signals KW - Speed UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1301.pdf UR - https://trid.trb.org/view/1243642 ER - TY - RPRT AN - 01470382 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Omega Aerial Refueling Services flight crashed on takeoff from runway 21, Point Mugu Naval Air Station, CA, May 18, 2011 PY - 2013/01/02 SP - 17p AB - On May 18, 2011, about 1727 Pacific daylight time, a modified Boeing 707, registration N707AR, operating as Omega Aerial Refueling Services (Omega) flight 70 crashed on takeoff from runway 21 at Point Mugu Naval Air Station, California (KNTD). The airplane collided with a marsh area to the left side beyond the departure end of the runway and was substantially damaged by post-impact fire. The three flight crew members sustained minor injuries. The flight was conducted under the provisions of a contract between Omega and the US Naval Air Systems Command (NAVAIR) to provide aerial refueling of Navy F/A-18s in offshore warning area airspace. According to the Federal Aviation Administration (FAA), Omega, and the US Navy, the airplane was operating as a nonmilitary public aircraft under the provisions of 49 United States Code Sections 40102 and 40125. The National Transportation Safety Board determines that the probable cause of this accident was the failure of a midspar fitting, which was susceptible to fatigue cracking and should have been replaced with a newer more fatigue-resistant version of the fitting as required by an airworthiness directive. Also causal was an erroneous maintenance entry made by a previous aircraft owner, which incorrectly reflected that the newer fitting had been installed. KW - Air transportation crashes KW - Crash analysis KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Refueling UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB1301.pdf UR - https://trid.trb.org/view/1238018 ER - TY - RPRT AN - 01478305 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted January 2013 PY - 2013/01 SP - 24p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of January 2013. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1247576 ER - TY - RPRT AN - 01539463 AU - National Transportation Safety Board TI - Safer Seas 2013: Lessons Learned from Marine Accident Investigations PY - 2013 SP - 43p AB - This document summarizes and compiles the marine accident investigations conducted by the National Transportation Safety Board and published in 2013. The accidents are grouped by vessel type so that readers can more easily find reports relevant to their area of interest. Each summary contains an overview of the accident along with probable causes. The appendices include links to the detailed investigation reports. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Ships KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/SaferSeas2013.pdf UR - https://trid.trb.org/view/1324565 ER - TY - RPRT AN - 01567269 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding of Mobile Offshore Drilling Unit Kulluk PY - 2012/12/31 SP - 14p AB - ​The ice-class mobile offshore drilling unit (MODU) Kulluk, owned by Shell Offshore, Inc., and operated by Noble Drilling, grounded in heavy weather near Ocean Bay on the eastern coast of Sitkalidak Island off Kodiak Island, Alaska, about 2040 local time on December 31, 2012. The Kulluk, under tow by the ice-class anchor-handling tow supply vessel Aiviq, departed Captains Bay near Unalaska, Alaska, 10 days earlier for the Seattle, Washington, area for maintenance and repairs. Four crewmembers on the Aiviq sustained minor injuries as a result of the accident. The National Transportation Safety Board determines that the probable cause of the grounding of the mobile offshore drilling unit Kulluk was Shell’s inadequate assessment of the risk for its planned tow of the Kulluk, resulting in implementation of a tow plan insufficient to mitigate that risk. KW - Cold weather KW - Crash causes KW - Crash investigation KW - Drilling machines KW - Groundings (Maritime crashes) KW - Kodiak Island (Alaska) KW - Marine safety KW - Mobile offshore drilling units KW - Risk management KW - Towboat operations UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1510.pdf UR - https://trid.trb.org/view/1356582 ER - TY - RPRT AN - 01471982 AU - National Transportation Safety Board TI - Highway Accident Report: Highway-Railroad Grade Crossing Collision, US Highway 95, Miriam, Nevada, June 24, 2011 PY - 2012/12/11 SP - 82p AB - On Friday, June 24, 2011, about 11:19 a.m. Pacific daylight time, a 2008 Peterbilt truck-tractor occupied by a 43-year-old driver was traveling north on US Highway 95 near Miriam, Nevada. The truck-tractor was pulling two empty 2007 side-dump trailers. As it approached an active highway–railroad grade crossing consisting of two cantilever signal masts with flashing lights and two crossing gate arms in the descended position, it failed to stop and struck the left side of Amtrak train no. 5, which was passing through the grade crossing from the northeast. The collision destroyed the truck-tractor and two passenger railcars. The train came to a stop without derailing; however, a fire ensued, engulfing two railcars and damaging a third railcar. The accident killed the truck driver, the train conductor, and four train passengers; 15 train passengers and one crewmember were injured. Major safety issues identified in this investigation were commercial driver fatigue and distraction, commercial driver license and employment history, commercial vehicle brake maintenance, passenger railcar crashworthiness and fire protection, and grade crossing action plans. The National Transportation Safety Board makes recommendations to the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration, the Federal Highway Administration, the Federal Railroad Administration, the Nevada Highway Patrol, the Commercial Vehicle Safety Alliance, the American Trucking Associations, the Owner-Operator Independent Drivers Association, the Towing and Recovery Association of America Inc., the American Bus Association, the United Motorcoach Association, and John Davis Trucking Company, Inc. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fires KW - Highway safety KW - Injuries KW - Railroad crashes KW - Railroad grade crossings KW - Railroad safety KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1203.pdf UR - https://trid.trb.org/view/1239258 ER - TY - RPRT AN - 01469385 AU - National Transportation Safety Board TI - Highway Special Investigation Report: Wrong-Way Driving PY - 2012/12/11 SP - 77p AB - This special investigation report looks at one of the most serious types of highway accidents -- collisions involving vehicles traveling the wrong way on high-speed divided highways. The goal of this investigative project is to identify relevant safety recommendations to prevent wrong-way collisions on such highways and access ramps. The investigations included in the report take a focused view of the driver and highway issues concerning wrong-way driving: driver impairment, primarily from alcohol use, with consideration of older driver issues and possible drug involvement; the need to establish, through traffic control devices and highway design, distinctly different views for motorists approaching entrance and exit ramps; monitoring and intervention programs for wrong-way collisions; and in-vehicle driver support systems. The report contains safety recommendations issued to the Federal Highway Administration; the National Highway Traffic Safety Administration; the states, the District of Columbia, and Puerto Rico; the American Association of State Highway and Transportation Officials; the Automotive Coalition for Traffic Safety, Inc.; the International Association of Chiefs of Police; the National Sheriffs' Association; SAE International; the Alliance of Automobile Manufacturers; Global Automakers; and the Consumer Electronics Association. KW - Aged drivers KW - Driver support systems KW - Highway design KW - Highway safety KW - Impaired drivers KW - Ramps (Interchanges) KW - Traffic control devices KW - Traffic crashes KW - Wrong way driving UR - http://www.ntsb.gov/safety/safety-studies/Documents/SIR1201.pdf UR - https://trid.trb.org/view/1237021 ER - TY - RPRT AN - 01456888 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Port Authority Trans-Hudson Train with Bumping Post at Hoboken Station, May 8, 2011 PY - 2012/11/05 SP - 18p AB - On May 8, 2011, about 8:32 a.m. eastern daylight time, Port Authority Trans-Hudson Corporation (PATH) train 820, consisting of seven multiple-unit electric locomotives, was routed to platform track 2 to offload passengers at the Hoboken station in Hoboken, New Jersey, when it struck the bumping post at the end of the track. It was estimated that 70 passengers were on board the train. As a result of the collision, 30 passengers, the engineer, and the conductor were transported to local hospitals with non-life-threatening injuries and released the same day. Five injured passengers refused medical attention on scene. PATH estimated total damages to be $352,617. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the engineer to control the speed of the train entering the station. Contributing to the accident was the lack of a positive train control system that would have intervened to stop the train and prevent the collision. KW - Crash causes KW - Crash investigation KW - Derailments KW - Hoboken (New Jersey) KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Railroad stations UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1205.pdf UR - https://trid.trb.org/view/1224026 ER - TY - RPRT AN - 01454426 AU - National Transportation Safety Board TI - 2013 Most Wanted List (Video) PY - 2012/11 AB - This video summarizes the top ten issues the National Transportation Safety Board (NTSB) will focus on in 2013. NTSB started their Most Wanted List in 1990 to generate increased public, government, and industry awareness and support for changes needed to reduce transportation accidents. The 2013 Most Wanted List includes: (1) Improve safety of airport surface operations; (2) Improve the safety of bus operations; (3) Eliminate distraction in transportation; (4) Improve fire safety in transportation; (5) Improve general aviation safety; (6) Preserve the integrity of transportation infrastructure; (7) Enhance pipeline safety; (8) Implement positive train control systems; (9) Eliminate substance-impaired driving; and (10) Mandate motor vehicle collision avoidance technologies. KW - Airport runways KW - Airport surface traffic control KW - Aviation safety KW - Bus crashes KW - Buses KW - Crash avoidance systems KW - Distraction KW - Fire safety KW - General aviation KW - Impaired drivers KW - Infrastructure KW - Infrastructure preservation KW - Pipeline safety KW - Positive train control KW - U.S. National Transportation Safety Board UR - http://www.youtube.com/watch?v=jJ6I-I_cmAk&feature=relmfu UR - https://trid.trb.org/view/1222938 ER - TY - RPRT AN - 01478335 AU - National Transportation Safety Board TI - Review of U.S. Civil Aviation Accidents, Calendar Year 2010 PY - 2012/10/10 SP - 73p AB - This document covers aircraft accidents regulated under United States Title 14 Code of Federal Regulations Parts 121 and 135 as well as general aviation accidents. In total, 1,500 accidents occurred in 2010, involving 1,520 U.S.-registered aircraft. Approximately 18% (275) of these accidents were fatal, resulting in 470 fatalities. General aviation accidents accounted for nearly 96% of total accidents and about 97% of fatal accidents in 2010. Data for the years 2001–2009 are included to provide historical context for the 2010 statistics. The details of the circumstances of the accidents are presented throughout this report. Readers may download a copy of the accident dataset at http://www.ntsb.gov/data/aviation_stats.html. KW - Air transportation crashes KW - Civil aviation KW - Crash rates KW - Fatalities KW - General aviation KW - Trend (Statistics) KW - United States UR - https://www.ntsb.gov/doclib/reports/2012/ARA1201.pdf UR - https://trid.trb.org/view/1246771 ER - TY - RPRT AN - 01454020 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash During Experimental Test Flight, Gulfstream Aerospace Corporation GVI (G650), N652GD, Roswell, New Mexico, April 2, 2011 PY - 2012/10/10 SP - 90p AB - This report discusses the April 2, 2011, accident involving an experimental Gulfstream Aerospace Corporation GVI (G650), N652GD, which crashed during takeoff from runway 21 at Roswell International Air Center, Roswell, New Mexico. The two pilots and the two flight test engineers were fatally injured and the airplane was substantially damaged by impact forces and a postcrash fire. Safety issues discussed in this report are the maximum lift coefficient for airplanes in ground effect; flight test standard operating policies and procedures; flight test-specific safety management system guidance; and coordination of high-risk test flights among flight test operators, airport operations, and aircraft rescue and firefighting personnel. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration, the Flight Test Safety Committee, and Gulfstream Aerospace Corporation. KW - Air transportation crashes KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Fatalities KW - Roswell (New Mexico) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1202.pdf UR - https://trid.trb.org/view/1218611 ER - TY - RPRT AN - 01455255 AU - National Transportation Safety Board TI - Marine Accident Report: Collision of the Tankship Elka Apollon With the Containership MSC Nederland, Houston Ship Channel, Upper Galveston Bay, Texas, October 29, 2011 PY - 2012/09/25 SP - 55p AB - The Elka Apollon, a Greek-flag tankship, was outbound on the Houston Ship Channel for Freeport, Texas, on the morning of October 29, 2011. The MSC Nederland, a Panamanian flag containership, was inbound on the same waterway to offload cargo at the Bayport Container Terminal at the western end of the Bayport Ship Channel. The pilots on the two deep draft, oceangoing vessels agreed by radio that their ships would meet and pass one another just south of the intersection of these two shipping channels. The pilot on the inbound MSC Nederland planned to let the Elka Apollon pass before turning to port into the Bayport channel. The pilot conning the Elka Apollon ordered a series of rudder commands as the vessel transited the intersection of the two channels and approached the MSC Nederland. A towboat, the Mr. Earl, under way in the vicinity and pushing an empty barge, was exiting the Bayport channel as the Elka Apollon was passing. As the distance between the Elka Apollon and the MSC Nederland closed, the Elka Apollon crossed the centerline of the Houston Ship Channel and subsequently struck the port side of the MSC Nederland. No injuries resulted from the collision. The impact caused structural damage to both vessels, and three damaged containers from the MSC Nederland fell onto the deck of the Elka Apollon. The collision also tore off the MSC Nederland's rescue boat and set it adrift in the waterway. Damage was estimated at $1.5 million for the Elka Apollon and $1.3 million for the MSC Nederland. The National Transportation Safety Board (NTSB) determines that the probable cause of the collision between the Elka Apollon and the MSC Nederland was the failure of the pilot conning the Elka Apollon to appropriately respond to changes in bank effect forces as the vessel transited the Bayport flare, causing the vessel to sheer across the channel and collide with the MSC Nederland. Contributing to the accident was the combination of the narrow waterway, bank effects at the Bayport flare, and traffic density at the time, which increased the challenges in a waterway with a limited margin for error. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Galveston Bay KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1202.pdf UR - https://trid.trb.org/view/1222606 ER - TY - RPRT AN - 01469991 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted August 2012 PY - 2012/08/31 SP - 15p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of August 2012. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1236770 ER - TY - RPRT AN - 01447539 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Pilot/Race 177, The Galloping Ghost, North American P-51D, N79111, Reno, Nevada, September 16, 2011 PY - 2012/08/27 SP - 52p AB - On September 16, 2011, about 1625 Pacific daylight time, an experimental, single-seat North American P-51D, N79111, collided with the airport ramp in the spectator box seating area following a loss of control during the National Championship Air Races unlimited class gold race at the Reno/Stead Airport (RTS), Reno, Nevada. The airplane was registered to Aero-Trans Corp (dba Leeward Aeronautical Sales), Ocala, Florida, and operated by the commercial pilot as Race 177, The Galloping Ghost, under the provisions of 14 Code of Federal Regulations Part 91. The pilot and 10 people on the ground sustained fatal injuries, and at least 64 people on the ground were injured (at least 16 of whom were reported to have sustained serious injuries). The airplane sustained substantial damage, fragmenting upon collision with the ramp. Visual meteorological conditions prevailed, and no flight plan had been filed for the local air race flight, which departed RTS about 10 minutes before the accident. The National Transportation Safety Board (NTSB) determines that the probable cause of this accident was the reduced stiffness of the elevator trim tab system that allowed aerodynamic flutter to occur at racing speeds. The reduced stiffness was a result of deteriorated locknut inserts that allowed the trim tab attachment screws to become loose and to initiate fatigue cracking in one screw sometime before the accident flight. Aerodynamic flutter of the trim tabs resulted in a failure of the left trim tab link assembly, elevator movement, high flight loads, and a loss of control. Contributing to the accident were the undocumented and untested major modifications to the airplane and the pilot's operation of the airplane in the unique air racing environment without adequate flight testing. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Crash reports KW - Fatalities KW - Fatigue cracking KW - Flutter (Aeronautics) KW - Loss of control UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB1201.pdf UR - https://trid.trb.org/view/1214777 ER - TY - RPRT AN - 01443823 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision between Two Miami-Dade Transit Metromovers, Miami, Florida, July 20, 2010 PY - 2012/08/02 SP - 11p AB - On July 20, 2010, about 5:39 p.m., eastern daylight time, an inbound Miami-Dade Transit (MDT) Metromover, traveling about 10 mph along a fixed guideway, struck the trailing end of another Metromover. The struck Metromover was stopped at Brickell Station near downtown Miami, Florida. There were a total of 45 passengers on board the two Metromovers. These Metromovers operate in a fully automatic mode without human operators. Sixteen passengers incurred minor injuries and were transported to, treated by, and released from local hospitals. At the time of the accident, weather conditions were clear, with winds of 20 mph and a temperature of 87° F. Total damages were estimated at $406,691. The National Transportation Safety Board determines that the probable cause of the accident was the Miami-Dade Transit rail traffic controllers’ decision to restart automated train operations without accounting for the location of all Metromovers following a safety shutdown after the signal rail had been damaged by a defective Metromover guide wheel. Contributing to the accident was inadequate oversight by Miami-Dade Transit. KW - Crash analysis KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Crashes KW - Miami Metromover KW - Miami-Dade County (Florida) KW - Miami-Dade Transit KW - Railroad crashes KW - Railroad safety KW - Transit crashes KW - Transit safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1206.pdf UR - https://trid.trb.org/view/1202509 ER - TY - RPRT AN - 01446028 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Roadway Departure and Overturn on Interstate 95, Near Doswell, Virginia, May 31, 2011 PY - 2012/07/31 SP - 71p AB - On Tuesday, May 31, 2011, approximately 4:55 a.m. eastern daylight time, a 2000 Setra 59-passenger motorcoach operated by Sky Express, Inc., occupied by a driver and 58 passengers, was traveling north on Interstate 95 in the right lane of the three northbound lanes near Doswell, Virginia. The motorcoach drifted from the highway to the right, struck a cable barrier, rotated counterclockwise around its vertical axis, overturned to the right, and rolled onto its roof. As a result of the accident, 4 of the 58 passengers were killed, 14 received serious injuries, and 35 received minor injuries. The driver sustained minor injuries and refused medical treatment. The accident investigation focused on the issues of driver fatigue, motorcoach deficiencies in roof strength and occupant protection, and the Federal Motor Carrier Safety Administration (FMCSA) failure to exercise adequate safety oversight of the accident motor carrier. As a result of the investigation, the National Transportation Safety Board makes three new recommendations to the FMCSA, reiterates previous recommendations to the FMCSA and the National Highway Traffic Safety Administration (NHTSA), reclassifies a previous recommendation to the FMCSA, and reiterates and reclassifies a previous recommendation to NHTSA. KW - Bus crashes KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Doswell (Virginia) KW - Fatalities KW - Highway safety KW - Interstate 95 KW - Interstate highways KW - Motor carriers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1202.pdf UR - https://trid.trb.org/view/1212460 ER - TY - RPRT AN - 01445985 AU - National Transportation Safety Board TI - Pipeline Accident Report: Enbridge Incorporated Hazardous Liquid Pipeline Rupture and Release, Marshall, Michigan, July 25, 2010 PY - 2012/07/10 SP - 164p AB - On Sunday, July 25, 2010, at 5:58 p.m., eastern daylight time, a segment of a 30-inch-diameter pipeline (Line 6B), owned and operated by Enbridge Incorporated ruptured in a wetland in Marshall, Michigan. The rupture occurred during the last stages of a planned shutdown and was not discovered or addressed for over 17 hours. During the time lapse, Enbridge twice pumped additional oil (81 percent of the total release) into Line 6B during two startups; the total release was estimated to be 843,444 gallons of crude oil. The oil saturated the surrounding wetlands and flowed into the Talmadge Creek and the Kalamazoo River. Local residents self-evacuated from their houses, and the environment was negatively affected. Cleanup efforts continue as of the adoption date of this report, with continuing costs exceeding $767 million. About 320 people reported symptoms consistent with crude oil exposure. No fatalities were reported. As a result of its investigation of this accident, the National Transportation Safety Board (NTSB) makes recommendations to the U.S. Secretary of Transportation, the Pipeline and Hazardous Materials Safety Administration (PHMSA), Enbridge, the American Petroleum Institute, the Pipeline Research Council International, the International Association of Fire Chiefs, and the National Emergency Number Association. The NTSB also reiterates a previous recommendation to PHMSA. KW - Crash causes KW - Crash investigation KW - Crude oil KW - Evacuation KW - Hazardous materials KW - Liquids KW - Marshall (Michigan) KW - Pipeline accidents KW - Pipeline safety KW - Residential areas KW - Wetlands UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR1201.pdf UR - https://trid.trb.org/view/1212813 ER - TY - RPRT AN - 01444822 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted June 2012 PY - 2012/06/30 SP - 32p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of June 2012. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1212335 ER - TY - RPRT AN - 01446007 AU - National Transportation Safety Board TI - Aircraft Incident Report: Runway Overrun, American Airlines Flight 2253, Boeing 757-200, N668AA, Jackson Hole, Wyoming, December 29, 2010 PY - 2012/06/18 SP - 74p AB - This report discusses the December 29, 2010, incident involving American Airlines flight 2253, a Boeing 757-200, N668AA, which ran off the departure end of runway 19 and came to a stop in deep snow after landing at Jackson Hole Airport, Jackson Hole, Wyoming. The occupants were not injured, and the airplane sustained minor damage. Safety issues identified in this incident include the following: inadequate pilot training for recognition of a situation in which the speedbrakes do not automatically deploy as expected after landing, lack of an alert to warn pilots when speedbrakes have not automatically deployed during the landing roll, lack of guidance for pilots of certain Boeing airplanes to follow when an unintended thrust reverser lockout occurs, lack of pilot training for multiple emergency and abnormal situations, and lack of pilot training emphasizing monitoring skills and workload management. As a result of this investigation, three new safety recommendations are issued and three existing safety recommendations are reiterated to the Federal Aviation Administration. KW - Air pilots KW - Air transportation crashes KW - Aviation safety KW - Brakes KW - Crash causes KW - Crash investigation KW - Landing KW - Pilot training KW - Runway overruns KW - Safety equipment UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1201.pdf UR - https://trid.trb.org/view/1213690 ER - TY - RPRT AN - 01383558 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Run-Off-the-Road and Collision With Vertical Highway Signpost, Interstate 95 Southbound, New York City, New York, March 12, 2011 PY - 2012/06/05 SP - 101p AB - On March 12, 2011, about 5:38 a.m., a 1999 Prevost 56-passenger motorcoach, operated by World Wide Travel of Greater New York, was traveling southbound on Interstate 95, en route from the Mohegan Sun Casino in Uncasville, Connecticut, to New York City, and carrying 32 passengers. Near mile marker 3.2, the motorcoach departed from the travel lanes, driving over the rumble strips on the right shoulder edge. It then crossed over the 10-ft-wide paved shoulder and struck a guardrail, traveling about 480 ft alongside and on the guardrail, before overturning and flattening it. The vehicle then collided with a vertical highway signpost consisting of two vertical 8-inch-diameter steel tubular poles linked by cross-beam diagonal metal supports. The support structure’s two poles entered the passenger compartment along the base of the passenger windows as the vehicle slid forward, resulting in the roof panel being torn from the bus body for almost its entire length. Fifteen passengers were killed, 17 passengers received serious-to-minor injuries, and the bus driver received minor injuries. Major safety issues identified in this investigation were motorcoach driver fatigue and onboard monitoring systems, commercial driver license history, heavy vehicle speed limiters, safety management systems and motor carrier safety ratings, roadside barriers for heavy commercial passenger vehicles, and occupant injuries and motorcoach crashworthiness. As a result of this accident investigation, the National Transportation Safety Board makes recommendations to the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration, the Federal Highway Administration, the American Association of State Highway and Transportation Officials, the American Bus Association, the National Motorcoach Network, and the United Motorcoach Association. KW - Bus crashes KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Fatalities KW - Highway safety KW - Interstate 95 KW - Interstate highways KW - Motor carriers KW - New York (New York) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1201.pdf UR - https://trid.trb.org/view/1148245 ER - TY - RPRT AN - 01454101 AU - National Transportation Safety Board TI - Aviation Safety Study: The Safety of Experimental Amateur-Built Aircraft PY - 2012/05/22 SP - 169p AB - Experimental amateur-built (E-AB) aircraft represent nearly 10% of the United States general aviation fleet, but these aircraft accounted for approximately 15% of the total, and 21% of the fatal, U.S. general aviation accidents in 2011. E-AB aircraft represent a growing segment of the U.S. general aviation fleet, a segment that now numbers nearly 33,000 aircraft. The National Transportation Safety Board undertook this study because of the popularity of E-AB aircraft, concerns over their safety record, and the absence of a contemporary and definitive analysis of E-AB aircraft safety. The study employed several different methods and data collection procedures to carefully examine this segment of U.S. civil aviation. This comprehensive approach resulted in a detailed characterization of the current E-AB aircraft fleet, pilot population, and associated accidents. Areas identified for safety improvement include expanding the documentation requirements for initial aircraft airworthiness certification, verifying the completion of Phase I flight testing, improving pilots‘ access to transition training and supporting efforts to facilitate that training, encouraging the use of recorded data during flight testing, ensuring that buyers of used E-AB aircraft receive necessary performance documentation, and improving aircraft identification in registry records. KW - Air transportation crashes KW - Aircraft KW - Airworthiness KW - Aviation safety KW - Experimental vehicles KW - Fatalities KW - General aviation aircraft KW - Home-built aircraft UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/SS1201.pdf UR - https://trid.trb.org/view/1218540 ER - TY - RPRT AN - 01470001 AU - National Transportation Safety Board TI - Railroad Accident Brief: Washington Metropolitan Area Transit Authority Rear-end Collision, Falls Church, Virginia, November 29, 2009 PY - 2012/05/17 SP - 8p AB - On November 29, 2009, about 4:28 a.m. eastern standard time, Washington Metropolitan Area Transit Authority (WMATA) Metrorail train 902 struck the rear of a standing WMATA train at the West Falls Church rail yard, which is located in Falls Church, Virginia. No passengers were on board either train at the time of the collision; however, two WMATA maintenance department car cleaners were on board the struck train. The employees sustained minor injuries from the accident and were treated and released by a local hospital. The operator of train 902 also sustained minor injuries and was treated and released by a local hospital. Damage to train equipment was estimated to be about $9 million. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the train operator to control the movement of his train as it approached the standing train, possibly due to his fatigue. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Falls Church (Virginia) KW - Fatigue (Physiological condition) KW - Rail transit KW - Railroad safety KW - Rear end crashes KW - Transit crashes KW - Transit safety KW - Washington Metropolitan Area Transit Authority UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1204.pdf UR - https://trid.trb.org/view/1226269 ER - TY - RPRT AN - 01446030 AU - National Transportation Safety Board TI - Railroad Accident Report: Washington Metropolitan Area Transit Authority Hi-Rail Maintenance Vehicle Strikes Two Wayside Workers Near the Rockville Station, Rockville, Maryland, January 26, 2010 PY - 2012/05/17 SP - 34p AB - On January 26, 2010, about 1:40 a.m., a hi-rail vehicle, a truck or automobile that can be operated on either highways or rails, operating about 0.9 miles north of the Washington Metropolitan Area Transit Authority Rockville Metro Station struck and fatally injured two automatic train control technicians who were working on the right-of-way replacing an impedance bond between the tracks. The hi-rail vehicle was traveling down the track in the reverse gear at about 13 mph. The National Transportation Safety Board determines that the probable cause of the accident was inadequate safeguards by the Washington Metropolitan Area Transit Authority to protect roadway workers from approaching hi-rail vehicles, and to ensure hi-rail operators were aware of any wayside work being performed. Contributing to the accident was the inadequate communication of vital information concerning ongoing work by the Operations Control Center; the lack of an appropriate and effective lookout by the hi-rail vehicle operator and crew to carefully observe the track on approach; and the ineffective lookout for trains and/or hi-rail vehicles on the part of the automatic train control technicians. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Maintenance personnel KW - Railroad crashes KW - Railroad safety KW - Road-rail vehicles KW - Rockville (Maryland) KW - Work zone safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1204.pdf UR - https://trid.trb.org/view/1212918 ER - TY - RPRT AN - 01376237 AU - National Transportation Safety Board TI - Railroad Accident Brief: Washington Metropolitan Area Transit Authority Derailment, Washington, D.C., February 12, 2010 PY - 2012/05/17 SP - 10p AB - On February 12, 2010, about 10:16 a.m., outbound Washington Metropolitan Area Transit Authority (WMATA) Red Line Metrorail train 156, consisting of six passenger cars, departed the Farragut North station on the No. 2 main track and was routed by the automatic train control system into a pocket track. The train operator completed the move into the pocket track and stopped the train briefly about 180 feet before the red signal at the exit from the pocket track. The operator then moved the train at 7 mph past the signal and through an electrically powered derail. The front wheel set of the lead car derailed, causing the operator to apply emergency braking and the train to stop 27.9 feet after the point of derailment. At the time of the accident, train 156 was carrying 345 passengers. A WMATA track supervisor was in the area of the derailment at the time when the rail Operations Control Center (OCC) was trying to establish communication with the train operator. The track supervisor assisted the operator with the subsequent train inspections and radio communications with the OCC, which instructed the operator to change the operating (controlling) position to the rear car and ask the passengers to move to the rear four cars. The rear four cars then were uncoupled from the derailed lead car and moved back to the Farragut North station, where emergency responders, police officers, and WMATA officials assisted the passengers with exiting at the platform. Three passengers sustained minor injuries: two passengers were treated on scene and released, and the third passenger was transported to a local hospital, treated, and released on the same day. Damage to the derailed lead car was about $174,000; track and signal damage was negligible. The National Transportation Safety Board determines that the probable cause of the accident was the train operator’s failure to follow proper operating procedures, which resulted in her operating the train past a red signal and over the interconnected derail. Contributing to the accident was the failure of WMATA management to provide proper supervision of the train operator, which resulted in the incomplete configuration of the train identification and destination codes leading to the routing of the train into the pocket track. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Rail transit KW - Railroad crashes KW - Railroad safety KW - Transit crashes KW - Transit safety KW - Washington Metropolitan Area KW - Washington Metropolitan Area Transit Authority UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1205.pdf UR - https://trid.trb.org/view/1143992 ER - TY - RPRT AN - 01446261 AU - National Transportation Safety Board TI - Railroad Accident Summary Report: Collision of Dakota, Minnesota & Eastern Railroad Freight Train and 19 Stationary Railcars, Bettendorf, Iowa, July 14, 2009 PY - 2012/04/30 SP - 28p AB - On July 14, 2009, about 2:08 a.m., central daylight time, southbound Dakota, Minnesota & Eastern Railroad freight train B61-13 went into Bettendorf Yard in Bettendorf, Iowa, due to a misaligned switch and struck 19 stationary railcars. The impact fatally injured the locomotive engineer and the conductor. There were no wayside signals or other devices to convey the position of the hand-operated switch on the main track leading into the north yard sufficiently in advance to allow the approaching train to stop. The train was moving at the authorized speed of 25 mph and was operating under valid track warrant authority. Track warrants are authorizations issued by a dispatcher for a train to occupy a certain segment of track for a certain period of time. Track warrant authority is obtained and released through communication between train crews and the dispatcher. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Iowa KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1203.pdf UR - https://trid.trb.org/view/1212543 ER - TY - RPRT AN - 01375250 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of BNSF Coal Train With the Rear End of Standing BNSF Maintenance-of-Way Equipment Train, Red Oak, Iowa, April 17, 2011 PY - 2012/04/24 SP - 93p AB - On April 17, 2011, about 6:55 a.m. central daylight time, eastbound BNSF Railway coal train C-BTMCNM0-26, BNSF 9159 East, travelling about 23 mph, collided with the rear end of standing BNSF Railway maintenance-of-way equipment train U-BRGCRI-15, BNSF 9470 East, near Red Oak, Iowa. The accident occurred near milepost 448.3 on main track number two on the Creston Subdivision of the BNSF Railway Nebraska Division. The collision resulted in the derailment of 2 locomotives and 12 cars. As a result of collision forces, the lead locomotive’s modular crew cab was detached, partially crushed, and involved in a subsequent diesel fuel fire. Both crewmembers on the striking train were fatally injured. Damage was in excess of $8.7 million. The National Transportation Safety Board determined that the probable cause of the accident was the failure of the crew of the striking train to comply with the signal indication requiring them to operate in accordance with restricted speed requirements and stop short of the standing train because they had fallen asleep due to fatigue resulting from their irregular work schedules and their medical conditions. KW - BNSF Railway KW - Crash causes KW - Derailments KW - Diseases and medical conditions KW - Fatalities KW - Fatigue (Physiological condition) KW - Fires KW - Freight trains KW - Loss and damage KW - Maintenance of way cars KW - Railroad crashes KW - Red Oak (Iowa) KW - Train crews UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1202.pdf UR - https://trid.trb.org/view/1142370 ER - TY - RPRT AN - 01374558 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Passenger Ferry Andrew J. Barberi With St. George Terminal, Staten Island, New York, May 8, 2010 PY - 2012/04/24 SP - 46p AB - This report discusses the May 8, 2010, allision of the Andrew J. Barberi with the St. George terminal at Staten Island. A total of 266 persons were on board the vessel. As a result of the accident, 50 people were injured, 3 of them seriously. Damages to the vessel and the terminal structure totaled $182,238. Although this accident was not a "major marine casualty" as defined at 49 Code of Federal Regulations (CFR) Part 850 and 46 CFR Subpart 4.40, the National Transportation Safety Board chose to investigate it because the Andrew J. Barberi was also involved in an allision in 2003. Eleven people died and 70 people were injured in that accident. Safety issues identified in this accident include undetected loss of propulsion control and lack of propeller pitch deviation alarms on vessels with controllable pitch or cycloidal propulsion, operational safety provided by safety management systems, and lack of voyage data recorders on U.S.-flag ferries. On the basis of its findings, the National Transportation Safety Board makes recommendations to the U.S. Coast Guard. KW - Allisions KW - Crash injuries KW - Ferries KW - Ferry terminals KW - Propulsion KW - Safety management KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1201.pdf UR - https://trid.trb.org/view/1142278 ER - TY - RPRT AN - 01375252 AU - National Transportation Safety Board TI - Hazardous Materials Accident Summary Report: Cargo Hose Rupture and Release of Anhydrous Ammonia During Offloading of a Werner Transportation Services Cargo Tank Motor Vehicle at the Tanner Industries Plant, Swansea, South Carolina, July 15, 2009 PY - 2012/04/12 SP - 28p AB - On July 15, 2009, about 8:00 a.m., a cargo transfer hose ruptured shortly after transfer of anhydrous ammonia began from a Werner Transportation Services, Inc. cargo tank truck to a storage tank at the Tanner Industries, Inc. facility in Swansea, South Carolina. A white cloud of anhydrous ammonia, a toxic-by-inhalation gas, moved from the parking lot of the facility across U.S. Highway 321 to a largely wooded area, where it eventually dissipated. About the same time, a motorist traveling north on the highway drove into the ammonia cloud, apparently tried to get away from the cloud, then got out of her car and died of ammonia poisoning. Seven people went to the Lexington Medical Center emergency department complaining of respiratory problems and dizziness; all seven patients were treated and released the same day. The anhydrous ammonia cloud caused temporary discoloration of vegetation in the area, including the leaves on the trees. Residents in the area sheltered in place, and U.S. Highway 321 was closed until about 2:00 p.m. on the day of the accident. The Lexington County Fire Service arrived on scene about 8:07 a.m. Property damage and losses were limited to the ruptured hose and about 6,895 pounds of the anhydrous ammonia that was released. The National Transportation Safety Board determined that the probable cause of the accident was Werner Transportation Services, Inc.’s use of a cargo hose assembly that was not chemically compatible with anhydrous ammonia. KW - Ammonia KW - Anhydrous ammonia KW - Cargo handling equipment KW - Crash causes KW - Fatalities KW - Hoses KW - Loss and damage KW - Rupture KW - Swansea (South Carolina) KW - Tank trucks UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM1201S.pdf UR - https://trid.trb.org/view/1142373 ER - TY - RPRT AN - 01373945 AU - National Transportation Safety Board TI - Railroad Accident Brief: Derailment of CSX Transportation Freight Train Q502-15 With Hazardous Materials Release PY - 2012/03/30 SP - 11p AB - On January 16, 2007, about 8:43 a.m., eastern standard time, northbound CSX Transportation (CSX) freight train Q502-15, traveling about 47 mph through a curve, derailed 26 of its 80 cars near Shepherdsville, Kentucky. Twelve of the derailed cars contained hazardous materials. Three of those cars breached and released significant amounts of flammable hazardous liquids, which ignited and burned. About 500 people were evacuated from the area near the accident. No one was injured during the derailment; however, 50 people and 2 emergency responders were treated at local hospitals for minor injuries related to the hazardous materials release and fire. CSX estimated the total costs associated with this accident at $22.4 million. The weather was dry and cloudy, although recent rains had left the soil well saturated. The temperature was 28° F with 14 mph winds. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the 18th rail car to properly negotiate a curve because of the inadequate side bearing clearance of the B-end truck assembly, likely due to a broken side bearing wedge plate attachment bolt, which caused a wheel to climb the rail, which derailed the car. Contributing to the derailment was the undesirable contact of the truck bolster bowl rim with the car body center plate and the hollow worn wheels on the 18th car, which further diminished the steering ability of the truck assembly. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - CSX Transportation KW - Derailments KW - Hazardous materials KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety KW - Shepherdsville (Kentucky) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1203.pdf UR - https://trid.trb.org/view/1141485 ER - TY - RPRT AN - 01373949 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of BNSF Freight Train G-CRKINB9-16H With Motor Vehicle at Highway-Rail Grade Crossing PY - 2012/03/29 SP - 13p AB - On March 23, 2011, at 4:25 p.m., a northbound Burlington Northern Santa Fe Railway (BNSF) freight train, G-CRKINB9-16H (BNSF 7363), collided with a 2008 Chevrolet Suburban departing the Longview Junction yard at a private grade crossing in Kelso, Washington. A Coach America driver was operating the Suburban. (Coach America was under contract to BNSF to transport operating crews.) A BNSF conductor, a student conductor, and a locomotive engineer were passengers in the Suburban. The driver, the student conductor, and the locomotive engineer were fatally injured. The conductor sustained serious injuries and was flown to Oregon Health & Science University Hospital in Portland, Oregon. The BNSF train crew was not injured. The Suburban was totaled at a cost of $30,000, and the lead BNSF train locomotive received $2,000 in damage. At the time of the accident, the weather was partly cloudy with a temperature of about 59° F. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the Suburban driver to stop his vehicle before he drove onto the tracks to ensure there were no approaching trains. Contributing to the accident was the placement of railroad equipment too close to the crossing, obscuring the visibility of approaching trains. KW - BNSF Railway KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Fatalities KW - Kelso (Washington) KW - Railroad crashes KW - Railroad safety UR - http://app.ntsb.gov/doclib/reports/2012/RAB1202.pdf UR - http://app.ntsb.gov/investigations/fulltext/RAB1202.html UR - https://trid.trb.org/view/1141486 ER - TY - RPRT AN - 01373951 AU - National Transportation Safety Board TI - Railroad Accident Report: Derailment of CN Freight Train U70691-18 With Subsequent Hazardous Materials Release and Fire, Cherry Valley, Illinois June 19, 2009 PY - 2012/02/14 SP - 113p AB - About 8:36 p.m., central daylight time, on Friday, June 19, 2009, eastbound Canadian National Railway Company freight train U70691-18, traveling at 36 mph, derailed at a highway/rail grade crossing in Cherry Valley, Illinois. The train consisted of 2 locomotives and 114 cars, 19 of which derailed. All of the derailed cars were tank cars carrying denatured fuel ethanol, a flammable liquid. Thirteen of the derailed tank cars were breached or lost product and caught fire. At the time of the derailment, several motor vehicles were stopped on either side of the grade crossing waiting for the train to pass. As a result of the fire that erupted after the derailment, a passenger in one of the stopped cars was fatally injured, two passengers in the same car received serious injuries, and five occupants of other cars waiting at the highway/rail crossing were injured. Two responding firefighters also sustained minor injuries. The release of ethanol and the resulting fire prompted a mandatory evacuation of about 600 residences within a 1/2-mile radius of the accident site. Monetary damages were estimated to total $7.9 million. The National Transportation Safety Board determines that the probable cause of the accident was the washout of the track structure that was discovered about 1 hour before the train‘s arrival, and the Canadian National Railway Company‘s (CN) failure to notify the train crew of the known washout in time to stop the train because of the inadequacy of the CN‘s emergency communication procedures. Contributing to the accident was the CN‘s failure to work with Winnebago County to develop a comprehensive storm water management design to address the previous washouts in 2006 and 2007. Contributing to the severity of the accident was the CN‘s failure to issue the flash flood warning to the train crew and the inadequate design of the DOT-111 tank cars, which made the cars subject to damage and catastrophic loss of hazardous materials during the derailment. KW - Canadian National Railways KW - Cherry Valley (Illinois) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Fires KW - Hazardous materials KW - Railroad crashes KW - Railroad grade crossings KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1201.pdf UR - https://trid.trb.org/view/1141487 ER - TY - RPRT AN - 01476656 AU - National Transportation Safety Board TI - Marine Accident Brief: Determination of Probable Cause: Fire On Board Passenger Vessel Malaspina PY - 2012/02/07 SP - 3p AB - The passenger vessel Malaspina was in dry dock in Ketchikan, Alaska, for scheduled repairs when a fire broke out on February 7, 2012, resulting in damage estimated between $500,000 and $750,000. No one was injured. The Malaspina was undergoing duct repair which required “hot work”―cutting, grinding, and welding. The National Transportation Safety Board determines that the probable cause of the fire on board the passenger vessel Malaspina was the failure of the shoreside work crew and fire watch to ensure that proper cooling had occurred before leaving the area where the repair work was conducted. Contributing to the accident was the work crew’s improper use and application of a welding curtain, placed horizontally as opposed to vertically, which allowed molten material to burn through the curtain and fall into the space below. KW - Alaska KW - Crash causes KW - Crash investigation KW - Fires KW - Marine safety KW - Passenger ships KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1302.pdf UR - https://trid.trb.org/view/1246339 ER - TY - RPRT AN - 01367176 AU - National Transportation Safety Board TI - Highway Accident Report: Multivehicle Collision, Interstate 44 Eastbound, Gray Summit, Missouri, August 5, 2010 PY - 2011/12/13 SP - 104p AB - On August 5, 2010, in Gray Summit, Missouri, traffic slowed in the approach to an active work zone on eastbound Interstate 44. A 2007 Volvo truck-tractor with no trailer was traveling in the right lane and had slowed or stopped behind traffic. About 10:11 a.m. central daylight time, a 2007 GMC Sierra extended cab pickup truck merged into the right lane and struck the rear of the Volvo tractor. This collision was the first in a series of three. Two school buses from St. James High School, St. James, Missouri, were approaching the slowed traffic and the collision ahead. The lead bus was a 71-passenger bus, occupied by 23 passengers. Following closely behind the lead bus was a 72-passenger bus, occupied by 31 passengers. Seconds after the lead bus passed a motorcoach that had stopped on the shoulder, it struck the rear of the GMC pickup. This collision—the second in the series—caused the pickup to overturn onto the back of the Volvo tractor. The front of the lead bus came to rest on top of the GMC pickup and the Volvo tractor. Moments later, the following bus struck the lead bus. As a result of this accident sequence, the driver of the GMC pickup and one passenger seated in the rear of the lead bus were killed. A total of 35 bus passengers, the 2 bus drivers, and the driver of the Volvo tractor were injured. Eighteen people were uninjured. Major safety issues identified in this investigation were the potential use of video event recorder data in monitoring and oversight of driver performance; driver distraction due to use of a portable electronic device; necessity of maintaining adequate focus on the forward roadway and keeping recommended minimum following distance; medical oversight of interstate commercial drivers; inadequate Missouri state school bus inspection regulations and procedures; absence of Missouri state oversight of motor carriers involved in pupil transportation; frequency of rear-end accidents; design of emergency exit windows on school buses; and absence of a Missouri state requirement for pretrip safety briefings for pupils traveling to an activity or on a field trip in a school bus or a school-chartered bus. The National Transportation Safety Board makes recommendations to the National Highway Traffic Safety Administration, the 50 states and the District of Columbia, the state of Missouri, the Missouri Department of Elementary and Secondary Education, CTIA–The Wireless Association, the Consumer Electronics Association, the National Association of State Directors of Pupil Transportation Services, the National Association for Pupil Transportation, and the National School Transportation Association. KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Fatalities KW - Interstate highways KW - Multiple vehicle crashes KW - Pickup trucks KW - School buses KW - Truck tractors KW - Work zones UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1103.pdf UR - https://trid.trb.org/view/1135975 ER - TY - RPRT AN - 01363958 AU - National Transportation Safety Board TI - Railroad Accident Report: Miami International Airport, Automated People Mover Train Collision with Passenger Terminal Wall, Miami, Florida, November 28, 2008 PY - 2011/11/08 SP - 40p AB - About 4:44 p.m., eastern standard time, on November 28, 2008, a three-car train operating along a fixed guideway on Concourse E at Miami International Airport near Miami, Florida, failed to stop at the passenger platform and struck a wall at the end of the guideway. Although a maintenance technician was monitoring train operations from the lead car of the train when the accident occurred, the train was operating in fully automatic mode without a human operator. The maintenance technician and five passengers on board the train were injured in the accident. One person on the passenger platform also required medical attention. The National Transportation Safety Board determines that the probable cause of this accident was the installation of a jumper wire that prevented the overspeed/overshoot system from activating to stop the train when the crystal within the primary program stop module failed. As a result of its investigation of this accident, the National Transportation Safety Board (NTSB) makes safety recommendations to the U.S. Department of Transportation, to the 50 states and the District of Columbia, to Miami-Dade County, and to Johnson Controls, Inc. The NTSB also reiterates a previously issued safety recommendation to the U.S. Department of Transportation. KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Crashes KW - Miami International Airport KW - People movers KW - Recommendations UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1101.pdf UR - https://trid.trb.org/view/1132759 ER - TY - RPRT AN - 01380402 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted November 2011 PY - 2011/11 SP - 40p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of November 2011. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1148135 ER - TY - RPRT AN - 01359282 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Monorails in Walt Disney World Resort PY - 2011/10/31 SP - 14p AB - About 2:00 a.m. on Sunday, July 5, 2009, two monorails collided on a fixed guideway system referred to as the Epcot beam near the Concourse station within Walt Disney World Resort in Lake Buena Vista, Florida. The accident occurred when the Pink monorail backed through an improperly aligned switch-beam and struck the Purple monorail. An operator and six passengers were on board the Purple monorail at the time of the collision. The operator was fatally injured; the passengers were not injured. The only occupant of the Pink monorail, the operator, was taken to a nearby hospital and treated and released. At the time of the accident, weather conditions were clear with light winds and a temperature of 76º Fahrenheit. One operating cab from each of the monorails was destroyed. Total damages were estimated at $24 million. The National Transportation Safety Board determines that the probable cause of the July 5, 2009, collision between two monorails at Walt Disney World Resort in Lake Buena Vista, Florida, was the shop panel operator’s failure to properly position switch-beam 9 and the failure of the monorail manager acting as the central coordinator to verify the position of switch-beam 9 before authorizing the reverse movement of the Pink monorail. Contributing to the accident was Walt Disney World Resort’s lack of standard operating procedures leading to an unsafe practice when reversing trains on its monorail system. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crashes KW - Fatalities KW - Monorail transportation KW - Railroad crashes KW - Railroad safety KW - Walt Disney World Resort UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1107.pdf UR - https://trid.trb.org/view/1125157 ER - TY - RPRT AN - 01362618 AU - National Transportation Safety Board TI - Special Report: Report on Curbside Motorcoach Safety PY - 2011/10/12 SP - 78p AB - Motorcoach safety has received increased public attention after several serious accidents during 2011, some of which involved curbside carriers. As a result, the National Transportation Safety Board conducted an investigation of motorcoach safety with a focus on curbside operations. This report (1) describes the characteristics of the curbside business model among interstate motorcoach carriers; (2) describes the safety record of interstate motorcoach carriers, including those that use a curbside business model; and (3) evaluates the adequacy of safety oversight for interstate motorcoach carriers using a curbside business model. KW - Bus lines KW - Bus transportation KW - Buses KW - Business practices KW - Curbside operators KW - Oversight KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR1101.pdf UR - https://trid.trb.org/view/1127544 ER - TY - RPRT AN - 01358630 AU - National Transportation Safety Board TI - Marine Accident Report: Collision of Tankship Eagle Otome with Cargo Vessel Gull Arrow and Subsequent Collision with the Dixie Vengeance Tow, Sabine-Neches Canal, Port Arthur, Texas, January 23, 2010 PY - 2011/09/27 SP - 89p AB - This report discusses the January 23, 2010, collision of the tankship Eagle Otome with the general cargo vessel Gull Arrow and the subsequent collision of tank barge Kirby 30406, pushed by towboat Dixie Vengeance, with the Eagle Otome. The accident occurred in the Sabine-Neches Canal in Port Arthur, Texas. The damages that resulted from this accident were $1.5 million to the Eagle Otome, $35,000 to the barge, and $381,000 to the Gull Arrow. No crewmember on board the three vessels was injured. As a result of the accident, an estimated 462,000 gallons of oil spilled into the water, and about 136 Port Arthur residents were temporarily evacuated from the area near the accident scene. Safety issues identified in this accident were pilot oversight, mariner fatigue, waterway safety, and bridge control ergonomics. As a result of the investigation, safety recommendations are issued to the U.S. Coast Guard, the Jefferson and Orange County Board of Pilot Commissioners, the Sabine Pilots Association, the American Pilots‘ Association, and governors of states and territories in which state and local pilots operate. KW - Bridges (Ships) KW - Crash investigation KW - Ergonomics KW - Fatigue (Physiological condition) KW - Loss and damage KW - Maritime safety KW - Oil spills KW - Port Arthur (Texas) KW - Recommendations KW - Sabine-Neches Canal KW - Ship pilotage KW - Ship pilots KW - Ships KW - Tank barges KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1104.pdf UR - https://trid.trb.org/view/1124240 ER - TY - RPRT AN - 01357315 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of Commercial Fishing Vessel Katmai PY - 2011/09/13 SP - 22p AB - About midnight on October 21–22, 2008, during a severe storm, the U.S. commercial fishing vessel Katmai sank in the Bering Sea. The vessel was carrying about 120,000 pounds (53.57 long tons) of frozen cod—twice the maximum weight addressed in the Katmai’s 1996 stability report. Of the 11 crewmembers on board, 4 were rescued, the bodies of 5 were recovered, and 2 remain missing and are presumed dead. National Transportation Safety Board (NTSB) investigators participated in a formal U.S. Coast Guard Marine Board of Investigation into the sinking, conducted on October 27–28, 2008, in Anchorage, Alaska, and on November 3 and December 10, 2008, in Seattle, Washington. Before the marine board convened, NTSB and Coast Guard investigators examined one of the vessel’s two liferafts, which had been taken to Anchorage after it was recovered. The marine board published its report in April 2010. This NTSB marine accident brief includes some of the 31 recommendations made to the Coast Guard by the Marine Board of Investigation, and these recommendations are noted in their respective subject areas. The NTSB determined that the probable cause of the sinking of the Katmai was the loss of the vessel’s watertight integrity because watertight doors from the main deck to the processing space and the lazarette were left open by the crew at a time when the vessel was overloaded and navigating in severe weather, which allowed water to enter the vessel resulting in progressive flooding and sinking. Contributing to the accident was the master’s decision to continue fishing operations during the approach of severe weather rather than seeking shelter and to load twice the amount of cargo addressed in the vessel’s stability report. Also contributing to the accident was the owner’s failure to ensure that the stability information provided to the master was current and that the master understood it and operated the vessel accordingly. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fishing vessels KW - Frozen cargo KW - Storms KW - Water transportation crashes KW - Weight UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1103.pdf UR - https://trid.trb.org/view/1122780 ER - TY - RPRT AN - 01356789 AU - National Transportation Safety Board TI - Highway Accident Report: Truck-Tractor Semitrailer Median Crossover Collision With 15-Passenger Van, Munfordville, Kentucky, March 26, 2010 PY - 2011/09/13 SP - 85p AB - On March 26, 2010, near Munfordville, Kentucky, a truck-tractor semitrailer was traveling south on Interstate 65 (I-65) when it departed the left lane and entered the 60-foot-wide depressed earthen median between the southbound and northbound roadways. The truck traveled across the median and struck and overrode the high-tension median cable barrier adjacent to the left shoulder of northbound I-65. It then crossed the shoulder and entered the lanes of northbound I-65. A 15-passenger van, containing 12 occupants, was traveling northbound in the left lane. As the truck crossed in front of the van, its tractor was struck by the van. As a result of the accident and the truck fire that ensued, the truck driver, the van driver, and nine van passengers died. Two child passengers in the van, who were using child restraints, sustained minor injuries. Among the safety issues addressed in the report are the need to prohibit the use of cellular telephones by drivers of commercial motor vehicles; the need to provide objective warrants, rather than general guidelines, for the application of median barriers; the need to revise state seat belt laws to include occupants of 15-passenger vans; the need to detect unsafe motor carriers attempting to obtain operating authority by submitting inaccurate or deceptive information to the Federal Motor Carrier Safety Administration (FMCSA); and the need to evaluate the performance of the FMCSA new entrant program. The National Transportation Safety Board is issuing 15 safety recommendations as a result of the investigation. KW - Cellular telephones KW - Child restraint systems KW - Crash injuries KW - Crossover accidents KW - Fatalities KW - Interstate 65 KW - Kentucky KW - Median barriers KW - Recommendations KW - Seat belts KW - Tractor trailer combinations KW - Truck crashes KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1101.pdf UR - https://trid.trb.org/view/1122441 ER - TY - RPRT AN - 01353554 AU - National Transportation Safety Board TI - Pipeline Accident Report: Pacific Gas and Electric Company Natural Gas Transmission Pipeline Rupture and Fire, San Bruno, California, September 9, 2010 PY - 2011/08/30 SP - 153p AB - On September 9, 2010, about 6:11 p.m. Pacific daylight time, a 30-inch-diameter segment of an intrastate natural gas transmission pipeline known as Line 132, owned and operated by the Pacific Gas and Electric Company, ruptured in a residential area in San Bruno, California. The rupture occurred at mile point 39.28 of Line 132, at the intersection of Earl Avenue and Glenview Drive. The rupture produced a crater about 72 feet long by 26 feet wide. The section of pipe that ruptured, which was about 28 feet long and weighed about 3,000 pounds, was found 100 feet south of the crater. The Pacific Gas and Electric Company estimated that 47.6 million standard cubic feet of natural gas was released. The released natural gas ignited, resulting in a fire that destroyed 38 homes and damaged 70. Eight people were killed, many were injured, and many more were evacuated from the area. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the U.S. Secretary of Transportation, the Pipeline and Hazardous Materials Safety Administration, the governor of the state of California, the California Public Utilities Commission, the Pacific Gas and Electric Company, the American Gas Association, and the Interstate Natural Gas Association of America. KW - Crash investigation KW - Evacuation KW - Explosions KW - Fatalities KW - Fires KW - Injuries KW - Loss and damage KW - Natural gas pipelines KW - Pipeline accidents KW - Pipeline safety KW - Recommendations KW - Residential areas KW - San Bruno (California) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR1101.pdf UR - https://trid.trb.org/view/1118312 ER - TY - RPRT AN - 01380380 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted August 2011 PY - 2011/08 SP - 48p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the National Transportation Safety Board during the month of August 2011. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1147561 ER - TY - RPRT AN - 01353557 AU - National Transportation Safety Board TI - Highway Accident Report: Rollover of a Truck-Tractor and Cargo Tank Semitrailer Carrying Liquefied Petroleum Gas and Subsequent Fire, Indianapolis, Indiana, October 22, 2009 PY - 2011/07/26 SP - 107p AB - On October 22, 2009, about 10:38 a.m. eastern daylight time, a 2006 Navistar International truck-tractor in combination with a 1994 Mississippi Tank Company MC331 specification cargo tank semitrailer (the combination unit), operated by AmeriGas Propane, L.P., and laden with 9,001 gallons of liquefied petroleum gas, rolled over on a connection ramp after exiting Interstate 69 (I-69) southbound to proceed south on Interstate 465 (I-465), about 10 miles northeast of downtown Indianapolis, Indiana. The truck driver was negotiating a left curve in the right lane on the connection ramp when the combination unit began to encroach upon the left lane, occupied by a 2007 Volvo S40 passenger car. The truck driver responded to the Volvo’s presence in the left lane by oversteering clockwise, causing the combination unit to veer to the right and travel onto the paved right shoulder. The truck driver’s excessive, rapid, evasive steering maneuver to return the combination unit to the roadway triggered a sequence of events that caused the cargo tank semitrailer to roll over, decouple from the truck-tractor, penetrate a steel W-beam guardrail, and collide with a bridge footing and concrete pier column supporting the southbound I-465 overpass. The collision entirely displaced the outside bridge pier column from its footing and resulted in a breach at the front of the cargo tank that allowed the liquefied petroleum gas to escape, form a vapor cloud, and ignite. The truck driver and the Volvo driver sustained serious injuries in the accident and postaccident fire, and three occupants of passenger vehicles traveling on I-465 received minor injuries from the postaccident fire. Major safety issues were identified in this investigation related to cargo tank rollover prevention. As a result of its investigation, the National Transportation Safety Board has issued safety recommendations to the U.S. Department of Transportation, Federal Motor Carrier Safety Administration, Pipeline and Hazardous Materials Safety Administration, National Highway Traffic Safety Administration, Federal Highway Administration, and American Association of State Highway and Transportation Officials. KW - Bridge piers KW - Crash injuries KW - Fires KW - Highway safety KW - Indianapolis (Indiana) KW - Liquefied petroleum gas KW - Loss and damage KW - Ramps (Interchanges) KW - Recommendations KW - Rollover crashes KW - Steering KW - Tank trucks KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1101.pdf UR - https://trid.trb.org/view/1118313 ER - TY - RPRT AN - 01354121 AU - National Transportation Safety Board TI - Aircraft Accident Report: Loss of Control While Maneuvering, Pilatus PC-12/45, N128CM, Butte, Montana, March 22, 2009 PY - 2011/07/12 SP - 90p AB - This accident report discusses the March 22, 2009, accident in which a Pilatus PC-12/45, N128CM, was diverting to Bert Mooney Airport (BTM), Butte, Montana, when it crashed about 2,100 feet west of runway 33 at BTM. The safety issues discussed in the report address fuel system limitations, requirements for fuel filler placards, and guidance on fuel system icing prevention. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration (FAA) and the European Aviation Safety Agency. Previous safety recommendations concerning crash protection for airplane occupants and flight recorder systems were addressed to the FAA. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fuel systems KW - Icing KW - Loss of control UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1105.pdf UR - https://trid.trb.org/view/1114717 ER - TY - RPRT AN - 01353066 AU - National Transportation Safety Board TI - Marine Accident Report: Collision Between U.S. Coast Guard Vessel CG 33118 and Sea Ray Recreational Vessel CF 2607 PZ, San Diego Bay, California, December 20, 2009 PY - 2011/07/12 SP - 72p AB - This report discusses the December 20, 2009, collision on San Diego Bay, California, between the 33-foot-long U.S. Coast Guard special purpose craft – law enforcement (SPC-LE) CG 33118 and an unnamed 24-foot-long Sea Ray recreational boat with California registration CF 2607 PZ. As a result of the accident, an 8-year-old passenger on board the Sea Ray died. Safety issues identified in this accident include the speed of the CG 33118, Coast Guard oversight of small boat operations, SPC-LE forward visibility, Coast Guard monitoring of small boat operational data, and Coast Guard use of personal cell phones while under way. On the basis of its findings, the NTSB made recommendations to the Coast Guard. KW - Cellular telephones KW - Fatalities KW - Marine safety KW - Recommendations KW - Recreational vessels KW - San Diego Bay KW - Small boats KW - Speed KW - United States Coast Guard KW - United States Coast Guard ships KW - Visibility KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1102.pdf UR - https://trid.trb.org/view/1117574 ER - TY - RPRT AN - 01343902 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision between USCG Boat CG 25689 and Passenger Vessel Thriller 09, December 5, 2009, Charleston Harbor, South Carolina PY - 2011/06/30 SP - 19p AB - On Saturday, December 5, 2009, at 2028 local time, the 25-foot-long U.S. Coast Guard response boat – small (RB-S) CG 25689 collided with the 55-foot-long small passenger vessel Thriller 09 in Charleston Harbor, South Carolina. Before the accident, the CG 25689, accompanied by the RB-S CG 25788, had been providing a security escort to the U.S. cargo ship Green Ridge, which was outbound to sea. At the time of the accident, the CG 25689 had completed the escort and was traveling back up the main shipping channel, returning to the Military Outload (MOL) detachment operations facility on Goose Creek. The Thriller 09 was on a 1-hour nighttime sightseeing cruise in Charleston Harbor. On board the CG 25689 were 3 crewmembers; on board the Thriller 09 were 2 crewmembers and 22 passengers. Following the accident, six passengers on the Thriller 09 sought and received medical treatment for injuries. No crewmembers on the CG 25689 or the Thriller 09 were injured. The Coast Guard was party to the National Transportation Safety Board (NTSB) investigation of the accident. The National Transportation Safety Board determines that the probable cause of the collision was the inadequate lookout by the crewmembers of both vessels, given the speed at which they were being operated and the nighttime conditions. KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Nighttime crashes KW - Small passenger vessels KW - United States Coast Guard ships KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1102.pdf UR - https://trid.trb.org/view/1106316 ER - TY - RPRT AN - 01353559 AU - National Transportation Safety Board TI - Marine Accident Report: Collision of Tugboat/Barge Caribbean Sea/The Resource with Amphibious Passenger Vehicle DUKW 34, Philadelphia, Pennsylvania, July 7, 2010 PY - 2011/06/21 SP - 89p AB - This report discusses the July 7, 2010, collision of the tugboat/barge combination Caribbean Sea/The Resource with the amphibious passenger vehicle DUKW 34 on the Delaware River in Philadelphia, Pennsylvania. As a result of the accident, two passengers on board DUKW 34 were fatally injured, and several other passengers sustained minor injuries. Damage to DUKW 34 totaled $130,470. Damage to the barge was minimal; no repairs were made. Safety issues identified in this accident include vehicle maintenance, maintaining an effective lookout, use of cell phones by crewmembers on duty, and response to the emergency by Ride The Ducks International personnel. As a result of this accident investigation, the National Transportation Safety Board makes safety recommendations to the U.S. Coast Guard, K-Sea Transportation Partners L.P., Ride The Ducks International, LLC, and The American Waterways Operators. KW - Amphibious vehicles KW - Barges KW - Cellular telephones KW - Crash injuries KW - Crash investigation KW - Delaware River KW - Emergency response KW - Fatalities KW - Loss and damage KW - Marine safety KW - Philadelphia (Pennsylvania) KW - Recommendations KW - Ship crews KW - Tugboats KW - Vehicle maintenance KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1102.pdf UR - https://trid.trb.org/view/1118348 ER - TY - RPRT AN - 01360695 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted June 2011 PY - 2011/06 SP - 30p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of June 2011. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1126487 ER - TY - RPRT AN - 01360663 AU - National Transportation Safety Board TI - National Transportation Safety Board Aircraft Accident Report: Crash After Encounter with Instrument Meteorological Conditions During Takeoff from Remote Landing Site, New Mexico State Police Agusta S.p.A. A-109E, N606SP, Near Santa Fe, New Mexico, on June 9, 2009 PY - 2011/05/24 SP - 89p AB - This accident report discusses the June 9, 2009, accident involving an Agusta S.p.A. A-109E helicopter, N606SP, which impacted terrain following visual flight rules flight into instrument meteorological conditions near Santa Fe, New Mexico. The commercial pilot and one passenger were fatally injured; a highway patrol officer who was acting as a spotter during the accident flight was seriously injured. The entire aircraft was substantially damaged. The helicopter was registered to the New Mexico Department of Public Safety and operated by the New Mexico State Police (NMSP) on a public search and rescue mission under the provisions of 14 Code of Federal Regulations Part 91 without a flight plan. The safety issues discussed in this report include the pilot’s decision-making, flight and duty times and rest periods, NMSP staffing, safety management system programs and risk assessments, communications between the NMSP pilots and volunteer search and rescue organization personnel, instrument flying, and flight-following equipment. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Crash reports KW - Helicopter pilots KW - Helicopters KW - Instrument flying KW - New Mexico KW - Police departments KW - Procedures KW - Recommendations KW - Search and rescue operations UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-reports/AAR11-04.pdf UR - https://trid.trb.org/view/1126705 ER - TY - RPRT AN - 01360622 AU - National Transportation Safety Board TI - National Transportation Safety Board Aircraft Accident Report: Collision into Mountainous Terrain, GCI Communication Corp., de Havilland DHC-3T, N455A, Aleknagik, Alaska, on August 9, 2010 PY - 2011/05/24 SP - 86p AB - This accident report discusses the August 9, 2010, accident involving a single-engine, turbine-powered, amphibious float-equipped de Havilland DHC-3T airplane, N455A, which impacted mountainous, tree-covered terrain about 10 nautical miles northeast of Aleknagik, Alaska. The safety issues discussed in this report relate to the lack of a Federal Aviation Administration (FAA) requirement for a crash-resistant flight recorder system, improperly designed or maintained emergency locator transmitter mounting and retention mechanisms, inadequate FAA guidance related to the medical certification of pilots who have had a cerebrovascular event, and the lack of passenger briefings related to survival and communications equipment. Although no weather data deficiencies were found to be related to the accident, the investigation also identified areas in which continued enhancements could further improve aviation safety. Four new safety recommendations concerning these issues are addressed to the FAA, and one new safety recommendation is addessed to the Aircraft Owners and Pilots Association; two safety recommendations to the FAA are reclassified; and two safety recommendations to the FAA are reiterated in this report. KW - Air pilots KW - Air transportation crashes KW - Alaska KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Crash reports KW - Diseases and medical conditions KW - Mountains KW - Procedures KW - Recommendations KW - Safety equipment KW - U.S. Federal Aviation Administration UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1103.pdf UR - https://trid.trb.org/view/1126704 ER - TY - RPRT AN - 01343389 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash After Encounter with Instrument Meteorological Conditions During Takeoff from Remote Landing Site, New Mexico State Police Agusta S.p.A. A-109E, N606SP, Near Santa Fe, New Mexico, June 9, 2009 PY - 2011/05/24 SP - 88p AB - This accident report discusses the June 9, 2009, accident involving an Agusta S.p.A. A-109E helicopter, N606SP, which impacted terrain following visual flight rules flight into instrument meteorological conditions near Santa Fe, New Mexico. The commercial pilot and one passenger were fatally injured; a highway patrol officer who was acting as a spotter during the accident flight was seriously injured. The entire aircraft was substantially damaged. The helicopter was registered to the New Mexico Department of Public Safety and operated by the New Mexico State Police (NMSP) on a public search and rescue mission under the provisions of 14 Code of Federal Regulations Part 91 without a flight plan. The safety issues discussed in this report include the pilot’s decision-making, flight and duty times and rest periods, NMSP staffing, safety management system programs and risk assessments, communications between the NMSP pilots and volunteer search and rescue organization personnel, instrument flying, and flight-following equipment. KW - AgustaWestland helicopters KW - Air pilots KW - Air transportation crashes KW - Communication KW - Crash injuries KW - Fatalities KW - Helicopters KW - Risk assessment KW - Safety management KW - Santa Fe (New Mexico) KW - Visual flight KW - Weather conditions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1104.pdf UR - https://trid.trb.org/view/1105240 ER - TY - RPRT AN - 01342391 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of U.S. Fishing Vessel Lady Mary, Atlantic Ocean, 65 Miles Southeast of Cape May, New Jersey, March 24, 2009 PY - 2011/05/02 SP - 15p AB - Between 0510 and 0540 on the morning of March 24, 2009, the fishing vessel Lady Mary sank in 210 feet of water in the Atlantic Ocean 65 miles off the New Jersey coast. Six crewmembers died in the accident, including the two owners, one of whom was the master. One crewmember survived. The sinking of the Lady Mary was investigated jointly by the National Transportation Safety Board (NTSB) and the U.S. Coast Guard, with the Coast Guard as the lead investigative agency. On March 30, 2009, the commandant of the Coast Guard convened a Marine Board of Investigation, which held a total of 9 days of hearings between April 14 and November 5 in Cape May, New Jersey. The NTSB participated fully in the Coast Guard hearing and investigation. The wreckage was surveyed by divers in May 2009 and extensively photographed. In October 2009, the Coast Guard, with the assistance of the U.S. Navy, retrieved the rudder and other equipment from the sunken vessel, which was sent for analysis to the materials laboratory at NTSB headquarters in Washington, DC. As of the date of this brief, the Coast Guard had not published its report on the Lady Mary accident. On March 11, 2010, the National Transportation Safety Board issued the following safety recommendation to the Federal Communications Commission: M-10-1 - For commercial vessels required to carry 406-MHz emergency position-indicating radio beacons (EPIRBs), mandate that those EPIRBs broadcast vessel position data when activated. KW - Crash investigation KW - Emergency Position Indicating Radio Beacon (EPIRB) KW - Fatalities KW - Fishing vessels KW - Recommendations KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1101.pdf UR - https://trid.trb.org/view/1104755 ER - TY - RPRT AN - 01358969 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted May 2011 PY - 2011/05 SP - 30p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of May 2011. KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1124327 ER - TY - RPRT AN - 01341120 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Municipal Transportation Agency Light Rail Vehicles, San Francisco, California, July 18, 2009 PY - 2011/04/13 SP - 8p AB - On July 18, 2009, about 2:50 p.m., at West Portal Station, San Francisco, California, San Francisco Municipal Railway Transit System (MUNI) L Line train 1433 struck the rear end of standing MUNI K Line train 1407. The operators of both trains and 46 passengers were taken to hospitals. The operator of the striking train and 27 of the passengers had serious injuries. The incident was not affected by weather; it occurred as the trains were just exiting a tunnel. Estimated damages were $4.5 million. The National Transportation Safety Board determines that the probable cause of the collision was the failure of the operator of L Line train 1407 to maintain the train in automatic mode until reaching the station stop at the West Portal platform, which would have been a safeguard against his loss of consciousness. Contributing to the accident was the San Francisco Municipal Railway Transit System’s failure to monitor and enforce the requirement that the operator wait until reaching the platform before changing the operating mode of the train. KW - Crash injuries KW - Human error KW - Light rail vehicles KW - Loss of consciousness KW - Operating mode (Engines) KW - Property damage KW - Railroad crashes KW - Rear end crashes KW - San Francisco (California) KW - San Francisco Municipal Railway KW - Transit operators UR - https://www.ntsb.gov/doclib/reports/2011/RAB1104.pdf UR - https://trid.trb.org/view/1103076 ER - TY - RPRT AN - 01341118 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Metrolink Passenger Train and BNSF Freight Train, Rialto, California, November 20, 2008 PY - 2011/04/13 SP - 7p AB - On Thursday, November 20, 2008, about 11:25 a.m., eastbound Metrolink passenger train 306 failed to stop at a red signal and had a raking side collision with the last eight cars and two rear locomotives of westbound Burlington Northern Santa Fe (BNSF) freight train LCAL 011120 that was entering a siding to meet the Metrolink train. The accident occurred at control point (CP) Lilac near Rialto, California. There were 15 passengers and 3 crew members on the Metrolink train. Four passengers received minor injuries. The two crew members of the BNSF freight train were unhurt. Neither train derailed. The weather was clear with calm winds, and the temperature was 76º F. The Metrolink train, which had one locomotive and four passenger cars, was about 400 feet long. The BNSF train, which consisted of 6 locomotives (4 at the front of the train and 2 at the rear) and 102 cars (96 loaded and 6 empty), was 6,926 feet long and weighed 12,201 tons. The left front corner of the locomotive of the Metrolink train was damaged when it scraped the BNSF train. The last eight cars and the 2 rear locomotives of the BNSF train were scraped by the Metrolink locomotive. The total damage was estimated to be $25,000. KW - BNSF Railway KW - Freight trains KW - Human error KW - Locomotive engineers KW - Metrolink (Los Angeles Metropolitan Area) KW - Property damage KW - Railroad crashes KW - Rialto (California) KW - Side crashes UR - https://www.ntsb.gov/doclib/reports/2011/RAB1105.pdf UR - https://trid.trb.org/view/1103075 ER - TY - RPRT AN - 01340442 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Massachusetts Bay Transportation Authority Light Rail Passenger Trains, Boston, Massachusetts, May 8, 2009 PY - 2011/04/13 SP - 10p AB - On Friday, May 8, 2009, about 7:14 p.m., westbound Massachusetts Bay Transportation Authority (MBTA) Green Line train 3612 struck the rear of standing westbound MBTA Green Line train 3808 near Government Center Station in Boston, Massachusetts. The accident occurred in the underground tunnel segment on the Green Line of the MBTA subway system. Each train consisted of two light-rail “married-pair” railcar sets. One car from each train derailed upright as a result of the collision. Sixty-eight injured passengers and crewmembers were transported to local hospitals. Monetary damages were estimated to be about $9.6 million. The National Transportation Safety Board determines that the probable cause of the May 8, 2009, collision of two Massachusetts Bay Transportation Authority Green Line Trains in Boston, Massachusetts, was the failure of the pilot operator of the striking train to observe and appropriately respond to the red signal aspect at 744A because he was engaged in the prohibited use of a wireless device, specifically text messaging, that distracted him from his duties. Contributing to the accident was the lack of a positive train control system that would have intervened to stop the train and prevent the collision. KW - Boston (Massachusetts) KW - Crash causes KW - Crash investigation KW - Crash reports KW - Distraction KW - Massachusetts Bay Transportation Authority KW - Rail transit KW - Text messaging KW - Transit crashes KW - Transit safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB1106.pdf UR - https://trid.trb.org/view/1100754 ER - TY - RPRT AN - 01341112 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted April 2011 PY - 2011/04 SP - 10p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of April 2011. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Safety KW - Transportation safety KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1103046 ER - TY - RPRT AN - 01526388 AU - National Transportation Safety Board TI - Review of U.S. Civil Aviation Accidents, 2007–2009 PY - 2011/03/31 SP - 68p AB - This Review of U.S. Civil Aviation Accidents, 2007–2009 reviews all civil aviation accidents investigated by the National Transportation Safety Board (NTSB) since the period covered by the 2006 Annual Reviews of Air Carrier and General Aviation Accidents. Both of those annual reviews were published in 2010, after the NTSB had determined the probable cause for virtually all of the accidents that had occurred during the reporting year. The present review is, thus, a significant departure from past practice, one that staff believes will provide for a more timely, comprehensive, and interesting review of the accident experience of U.S. civil aviation. Civil aviation in the United States encompasses an extremely wide range of aircraft operations, from pleasure flights in light sport aircraft to helicopter emergency medical service (HEMS) operations to scheduled domestic and international passenger service in large transport aircraft. The first change in the format of this report is to include this entire range of flying within one document to provide a more comprehensive picture of U.S. civil aviation. The statistical summaries in this report employ a coding structure developed by the Commercial Aviation Safety Team (CAST) of the International Civil Aviation Organization (ICAO) to describe the important circumstances of aviation accidents, rather than the probable cause determined by the NTSB for each individual accident. This change allows for the publication of a more timely report without diminishing its descriptive rigor. Probable cause for each accident will be published on the NTSB website as soon as it is available, and will also be used in aggregate analyses in statistical studies of specific safety issues conducted periodically. KW - Air transportation crashes KW - Civil aviation KW - Crash characteristics KW - Crash rates KW - Fatalities KW - General aviation KW - Trend (Statistics) KW - United States UR - http://www.ntsb.gov/investigations/data/Documents/ARA1101.pdf UR - https://trid.trb.org/view/1309822 ER - TY - RPRT AN - 01340650 AU - National Transportation Safety Board TI - Railroad Accident Brief: Employee Fatality while Switching Cars in Railroad Yard, Selkirk, New York, May 10, 2009 PY - 2011/03/31 SP - 6p AB - On Sunday, May 10, 2009, about 6:38 p.m., a CSX Transportation (CSX) remote control operator (RCO) was struck and killed by a train consisting of a remote controlled locomotive and seven cars (yard job number Y296-10). At the time of the accident, the RCO was working alone on track 23 in Selkirk Yard in Selkirk, New York. The RCO was controlling the train remotely at the east end of the yard and was planning to couple additional cars in preparation for movement onto another track. Before the RCO could add the additional cars, he had to replace a missing coupler knuckle on what was to be the eighth car of the train consist. He was in the process of coupling the seventh and eighth cars when the moving equipment struck him. At the time of the accident, it was daylight and sunny, and the temperature was 54° F. The National Transportation Safety Board determines that the probable cause of the CSX Transportation RCO being struck and killed was the operator’s loss of situational awareness when he stepped between moving equipment while attempting to couple the equipment, in violation of CSX Safety Rule TS-15. KW - Crash causes KW - Crash investigation KW - CSX Transportation KW - Fatalities KW - Human error KW - Operators (Persons) KW - Railroad crashes KW - Railroad yards KW - Safety rules KW - Selkirk (New York) KW - Switching UR - https://www.ntsb.gov/doclib/reports/2011/RAB1101.pdf UR - https://trid.trb.org/view/1102728 ER - TY - RPRT AN - 01339672 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash During Attempted Go‐Around After Landing, East Coast Jets Flight 81, Hawker Beechcraft Corporation 125‐800A, N818MV, Owatonna, Minnesota, July 31, 2008 PY - 2011/03/15 SP - 149p AB - This accident report discusses the July 31, 2008, accident involving East Coast Jets flight 81, a Hawker Beechcraft Corporation 125-800A, N818MV, which crashed while attempting to go around after landing on runway 30 at Owatonna Degner Regional Airport, Owatonna, Minnesota. The two pilots and six passengers were killed, and the airplane was destroyed by impact forces. The nonscheduled, domestic passenger flight was operating under the provisions of 14 Code of Federal Regulations (CFR) Part 135. An instrument flight rules flight plan had been filed and activated; however, it was canceled before the landing. Visual meteorological conditions prevailed at the time of the accident. The safety issues discussed in this report relate to flight crew actions; lack of standard operating procedures requirements for 14 CFR Part 135 operators, including crew resource management training and checklist usage; go-around guidance for turbine-powered aircraft; Part 135 preflight weather briefings; pilot fatigue and sleep disorders; inadequate arrival landing distance assessment guidance and requirements; Part 135 on-demand, pilot-in-command line checks; and cockpit image recording systems. Fourteen new safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air pilots KW - Air transportation crashes KW - Aircraft pilotage KW - Crash landing KW - Crew resource management KW - Fatalities KW - Fatigue (Physiological condition) KW - Flight crews KW - Owatonna (Minnesota) KW - Owatonna Degner Regional Airport KW - Sleep disorders KW - Training KW - United States Code. Title 14. Part 135 KW - Weather conditions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1101.pdf UR - https://trid.trb.org/view/1102385 ER - TY - RPRT AN - 01342713 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted March 2011 PY - 2011/03 SP - 50p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of March 2011. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Safety KW - Transportation safety KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/1103160 ER - TY - RPRT AN - 01336950 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted February 2011 PY - 2011/02 SP - 31p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of February 2011. KW - Air transportation KW - Crash investigation KW - Crash prevention KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/1098765 ER - TY - RPRT AN - 01337272 AU - National Transportation Safety Board TI - Aviation Safety Study: Airbag Performance in General Aviation Restraint Systems PY - 2011/01/11 SP - 139p AB - In 2003, airbags were first certificated for pilot and copilot seats on general aviation (GA) aircraft, and as of August 2010, they have been installed in nearly 18,000 seats in over 7,000 GA aircraft. In 2006, the National Transportation Safety Board (NTSB) initiated an exploratory case series study to consider airbag performance in GA accidents. The goals of the study were (1) to examine the effectiveness of airbags in mitigating occupant injury in GA accidents, (2) to identify any unintended consequences of airbag deployments, and (3) to develop procedures to assist investigators in documenting airbag systems in future investigations. During the 3-year data collection period, researchers tracked 145 notifications of events involving airbag-equipped airplanes which yielded 10 airbag-equipped GA airplane accidents that met the study criteria and were subjected to a full review and analysis by a multidisciplinary team. There were no unexpected deployments or unintended consequences identified during the study period. When adjusted correctly, the deployment of the airbag systems did not result in any negative outcomes, and in certain cases, deployment mitigated the severity of occupant injuries. The NTSB concluded that aviation airbags can mitigate occupant injuries in severe but survivable crashes in which the principal direction of force is longitudinal. During the course of the study, the study team also became aware of several potential issues that may compromise occupant safety associated with use, adjustment, or design of restraint systems. The report discusses steps that could be taken to address these safety issues and suggests future research directions in the area of GA occupant protection. Finally, as a result of the study, guidance for NTSB investigators was developed and disseminated, including a formal process for gathering data about airbag installations and deployments in accident aircraft. KW - Air bags KW - Air transportation crashes KW - Aviation safety KW - Crash analysis KW - General aviation aircraft KW - Injury severity KW - Performance UR - http://www.ntsb.gov/safety/safety-studies/Documents/SS1101.pdf UR - https://trid.trb.org/view/1097230 ER - TY - RPRT AN - 01333859 AU - National Transportation Safety Board TI - Marine Accident Report: Collision Between U.S. Passenger Ferry M/V Block Island and U.S. Coast Guard Cutter Morro Bay, Block Island Sound, Rhode Island, July 2, 2008 PY - 2011 SP - 54p AB - This report discusses the July 2, 2008, collision between the Coast Guard cutter Morro Bay and the passenger ferry M/V Block Island on Block Island Sound. The ferry was carrying a total of 305 people and the cutter had 21 crewmembers on board. As a result of the collision, two passengers on the Block Island sustained minor injuries and were treated and released that same afternoon. The Block Island sustained about $45,000 in damage and the Morro Bay about $15,000. Safety issues identified in this accident include failure to follow “rules of the road” in reduced visibility, ineffective use of the radars on board both vessels, and lack of safety management systems and voyage data recorders on U.S. passenger ferries. As a result of its investigation, the National Transportation Safety Board makes new recommendations to the Coast Guard and the Block Island’s operating company, and reiterates an existing recommendation to the Coast Guard. KW - Crash injuries KW - Crash reports KW - Cutters (Vessels) KW - Data recorders KW - Ferries KW - Loss and damage KW - Radar KW - Recommendations KW - Safety management KW - United States Coast Guard ships KW - Visibility KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR1101.pdf UR - https://trid.trb.org/view/1097337 ER - TY - RPRT AN - 01329759 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash During Takeoff of Carson Helicopters, Inc., Firefighting Helicopter Under Contract to the U.S. Forest Service, Sikorsky S‐61N, N612AZ, Near Weaverville, California, August 5, 2008 PY - 2010/12/07 SP - 175p AB - This accident summary report discusses the August 5, 2008, accident involving a Sikorsky S-61N helicopter, N612AZ, which impacted trees and terrain during the initial climb after takeoff from Helispot 44 (H-44), located at an elevation of about 6,000 feet in mountainous terrain near Weaverville, California. The pilot-in-command, the safety crewmember, and seven firefighters were fatally injured; the copilot and three firefighters were seriously injured. Impact forces and a postcrash fire destroyed the helicopter, which was being operated by the U.S. Forest Service (USFS) as a public flight to transport firefighters from H-44 to another helispot. The USFS had contracted with Carson Helicopters, Inc. (CHI), of Grants Pass, Oregon, for the services of the helicopter, which was registered to CHI and leased to Carson Helicopter Services, Inc. of Grants Pass. Visual meteorological conditions prevailed at the time of the accident, and a company visual flight rules flight plan had been filed. The safety issues discussed in this report involve the accuracy of hover performance charts, USFS and Federal Aviation Administration (FAA) oversight, flight crew performance, accident survivability, weather observations at helispots, fuel contamination, flight recorder requirements, and certification of seat supplemental type certificates. Safety recommendations concerning these issues are addressed to the FAA and the USFS. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fire fighting KW - Helicopters UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1006.pdf UR - https://trid.trb.org/view/1090649 ER - TY - RPRT AN - 01333175 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted December 2010 PY - 2010/12 SP - 34p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of December 2010. KW - Air transportation KW - Aviation safety KW - Highway transportation KW - Mode choice KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/1094122 ER - TY - RPRT AN - 01329324 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted November 2010 PY - 2010/11 SP - 42p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of November 2010. KW - Air transportation KW - Crash investigation KW - Crash prevention KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/1090691 ER - TY - RPRT AN - 01328141 AU - National Transportation Safety Board TI - Highway Accident Report: Truck‐Tractor Semitrailer Rear‐End Collision Into Passenger Vehicles on Interstate 44, Near Miami, Oklahoma, June 26, 2009 PY - 2010/09/28 SP - 109p AB - About 1:19 p.m. on June 26, 2009, a multivehicle accident occurred on Interstate 44 (I-44) near Miami, Oklahoma, shortly after a minor accident in the vicinity had resulted in a traffic queue. A truck driver operating a Volvo truck-tractor in combination with an empty semitrailer was traveling eastbound in the outside lane of I-44. He did not react to the queue of slowing and stopped vehicles ahead and collided with the rear of a Land Rover sport utility vehicle (SUV). As both vehicles moved forward, the Land Rover struck a Hyundai Sonata and then departed the right lane and shoulder. The Volvo continued forward, struck and overrode the Hyundai Sonata, struck and overrode a Kia Spectra, and then struck the rear of a Ford Windstar minivan. The Volvo overrode a portion of the Windstar while pushing it into the rear of a trailer being towed by a Ford F350 pickup truck. The pickup was pushed into a Chevrolet Tahoe SUV. As a result of the accident, 10 passenger vehicle occupants died, 5 received minor-to-serious injuries, and the Volvo combination unit driver was seriously injured. The major safety issues identified were the accident truck driver’s fatigue, the need for updated and comprehensive fatigue education materials and fatigue management programs, the significance of heavy vehicle aggressivity in collisions between dissimilar vehicles, the lack of Federal requirements for heavy commercial vehicle event data recorders and video event recorders, and the lack of Federal requirements for forward collision warning systems. KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatigue (Physiological condition) KW - Highway safety KW - Passenger vehicles KW - Rear end crashes KW - Tractor trailer combinations KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1002.pdf UR - https://trid.trb.org/view/1086323 ER - TY - RPRT AN - 01226614 AU - National Transportation Safety Board TI - Aircraft Accident Summary Report: Midair Collision Over Hudson River, Piper PA-32R-300, N71MC and Eurocopter AS350BA, N401LH Near Hoboken, New Jersey, August 8, 2009 PY - 2010/09/14 SP - 54p AB - This accident summary report discusses the August 8, 2009, accident involving a Piper PA-32R-300 airplane, N71MC, and a Eurocopter AS350BA helicopter, N401LH, operated by Liberty Helicopters, which collided over the Hudson River near Hoboken, New Jersey. The pilot and two passengers aboard the airplane and the pilot and five passengers aboard the helicopter were killed, and both aircraft received substantial damage from the impact. The airplane flight was operating under the provisions of 14 Code of Federal Regulations (CFR) Part 91, and the helicopter flight was operating under the provisions of 14 CFR Parts 135 and 136. No flight plans were filed or were required for either flight, and visual meteorological conditions prevailed at the time of the accident. The safety issues discussed in this report address changes within the recently designated special flight rules area (SFRA) surrounding the Hudson River corridor, vertical separation among aircraft operating in the Hudson River SFRA, the see-and-avoid concept, and helicopter electronic traffic advisory systems. Five new safety recommendations to the Federal Aviation Administration are included in the report. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Hoboken (New Jersey) KW - Midair crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1005.pdf UR - https://trid.trb.org/view/987331 ER - TY - RPRT AN - 01329696 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. General Aviation, Calendar Year 2006 PY - 2010/07/30 SP - 61p AB - In calendar year 2006, 1,523 general aviation accidents occurred, involving 1,535 aircraft, 147 fewer accidents than in 2005 and a drop of about 9%. Slightly more than 20% of these accidents were fatal (308), resulting in 706 total fatalities. Thus, while the number of fatal general aviation accidents in 2006 decreased 4% from calendar year 2005, the total number of fatalities increased by over 25%. The circumstances of these accidents and details related to the aircraft, pilots, and locations are presented throughout this review. KW - Air transportation crashes KW - Aviation safety KW - Crash locations KW - Fatalities KW - General aviation KW - General aviation aircraft KW - General aviation pilots UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARG10-01.pdf UR - https://trid.trb.org/view/1089741 ER - TY - RPRT AN - 01173892 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Two Washington Metropolitan Area Transit Authority Metrorail Trains Near Fort Totten Station, Washington, D.C., June 22, 2009 PY - 2010/07/27 SP - 156p AB - On Monday, June 22, 2009, about 4:58 p.m., eastern daylight time, inbound Washington Metropolitan Area Transit Authority Metrorail train 112 struck the rear of stopped inbound Metrorail train 214. The accident occurred on aboveground track on the Metrorail Red Line near the Fort Totten station in Washington, D.C. The lead car of train 112 struck the rear car of train 214, causing the rear car of train 214 to telescope into the lead car of train 112, resulting in a loss of occupant survival space in the lead car of about 63 feet (about 84 percent of its total length). Nine people aboard train 112, including the train operator, were killed. Emergency response agencies reported transporting 52 people to local hospitals. Damage to train equipment was estimated to be $12 million. The National Transportation Safety Board determines that the probable cause of the June 22, 2009, collision of Washington Metropolitan Area Transit Authority (WMATA) Metrorail train 112 with the rear of standing train 214 near the Fort Totten station was (1) a failure of the track circuit modules, built by GRS/Alstom Signaling Inc., that caused the automatic train control system to lose detection of train 214 (the struck train) and thus transmit speed commands to train 112 (the striking train) up to the point of impact, and (2) WMATA’s failure to ensure that the enhanced track circuit verification test (developed following the 2005 Rosslyn near-collisions) was institutionalized and used systemwide, which would have identified the faulty track circuit before the accident. Contributing to the accident were (1) WMATA’s lack of a safety culture, (2) WMATA’s failure to effectively maintain and monitor the performance of its automatic train control system, (3) GRS/Alstom Signaling Inc.’s failure to provide a maintenance plan to detect spurious signals that could cause its track circuit modules to malfunction, (4) ineffective safety oversight by the WMATA Board of Directors, (5) the Tri-State Oversight Committee’s ineffective oversight and lack of safety oversight authority, and (6) the Federal Transit Administration’s lack of statutory authority to provide federal safety oversight. Contributing to the severity of passenger injuries and the number of fatalities was WMATA’s failure to replace or retrofit the 1000-series railcars after these cars were shown in a previous accident to exhibit poor crashworthiness. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the U.S. Department of Transportation, the Federal Transit Administration, the Tri-State Oversight Committee, the Board of Directors of the Washington Metropolitan Area Transit Authority, the Washington Metropolitan Area Transit Authority, Alstom Signaling Inc., and six transit systems that use General Railway Signal Company track circuit modules (Massachusetts Bay Transportation Authority, Southeastern Pennsylvania Transportation Authority, Greater Cleveland Regional Transit Authority, Metropolitan Atlanta Regional Transportation Authority, Los Angeles County Metropolitan Transportation Authority, and Chicago Transit Authority). KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Crash reports KW - Fatalities KW - Rail transit KW - Transit crashes KW - Transit safety KW - Washington (District of Columbia) KW - Washington Metropolitan Area Transit Authority UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1002.pdf UR - https://trid.trb.org/view/934283 ER - TY - RPRT AN - 01173850 AU - National Transportation Safety Board TI - Aviation Accident Report: Runway Side Excursion During Attempted Takeoff in Strong and Gusty Crosswind Conditions, Continental Airlines Flight 1404, Boeing 737-500, N18611, Denver, Colorado, December 20, 2008 PY - 2010/07/13 SP - 117p AB - This report describes an accident that occurred on December 20, 2008, about 1818 mountain standard time, in which Continental Airlines flight 1404, a Boeing 737-500, N18611, departed the left side of runway 34R during takeoff from Denver International Airport, Denver, Colorado. A postcrash fire ensued. The captain and 5 of the 110 passengers were seriously injured; the first officer, 2 cabin crewmembers, and 38 passengers received minor injuries; and 1 cabin crewmember and 67 passengers (3 of whom were lap-held children) were uninjured. The airplane was substantially damaged. The safety issues discussed in this report include the pilots’ actions, training, and experience; air traffic controllers’ obtaining and disseminating wind information; runway selection and use; crosswind training; simulator modeling; crosswind guidelines and limitations; certification and inspection of crew seats; and galley latches. KW - Air transportation crashes KW - Airport runways KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Denver (Colorado) KW - Denver International Airport UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1004.pdf UR - https://trid.trb.org/view/934321 ER - TY - RPRT AN - 01164221 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire On Board U.S. Small Passenger Vessel Fire Island Belle, Fair Harbor, New York, September 20, 2009 PY - 2010/07/02 SP - 14p AB - On September 20, 2009, at 1010 eastern daylight time, the passenger ferry Fire Island Belle, with 100 passengers, the vessel master, and two deckhands on board, experienced an engineroom fire in the Great South Bay between Long Island and Fire Island, New York. The vessel had departed Ocean Beach, Fire Island, 10 minutes earlier, and was approximately 300 yards from the dock at Fair Harbor, Fire Island, when the fire broke out. No passengers or crewmembers were injured, and no pollution resulted. The cost of repairing the vessel was $490,000. The U.S. Coast Guard was the lead investigative agency in the accident. The National Transportation Safety Board (NTSB) provided assistance with fire investigation and metallurgical analysis. The National Transportation Safety Board determines that the probable cause of the engineroom fire on the Fire Island Belle was the ignition of fuel that had leaked from a fatigue-fractured fitting on the center engine’s secondary fuel filter, sprayed onto the lagging around the port engine exhaust duct, and seeped through a gap in the lagging onto the hot duct, where it caught fire. KW - Crash analysis KW - Crash investigation KW - Fire KW - Fire causes KW - Marine safety KW - Passenger ships KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1002.pdf UR - https://trid.trb.org/view/921504 ER - TY - RPRT AN - 01165321 AU - National Transportation Safety Board TI - Highway Accident Report: Bus Loss of Control and Rollover, Dolan Springs, Arizona, January 30, 2009 PY - 2010/06/22 SP - 78p AB - On Friday, January 30, 2009, about 4:06 p.m. mountain standard time, a 2007 Chevrolet/Starcraft 29-passenger medium-size bus, operated by DW Tour and Charter and occupied by the driver and 16 passengers, was traveling northbound in the right lane of U.S. Highway 93, a four-lane divided highway, near Dolan Springs, Arizona. The bus was on a return trip from Grand Canyon West to Las Vegas, Nevada, after a day-long tour. As the bus approached milepost 28 at an estimated speed of 70 mph, it moved to the left and out of its lane of travel. The driver steered sharply back to the right, crossing both northbound lanes and entering the right shoulder. The driver subsequently overcorrected to the left, causing the bus to yaw and cross both northbound lanes. The bus then entered the depressed earthen median and overturned 1.25 times before coming to rest on its right side across both southbound lanes. During the rollover sequence, 15 of the 17 occupants (including the driver) were fully or partially ejected. Seven passengers were killed, and nine passengers and the driver were injured. Major safety issues identified in this investigation were the failure of the bus driver to attend to the road ahead and maintain control of his vehicle; the need for regulatory definitions and classifications for bus body types; the limitations of medium-size buses in retaining and protecting passengers during rollovers; the need for technology to assist commercial drivers in maintaining control of their vehicles; and the need for event data recording in commercial vehicles to aid in accident reconstruction and safety research. As a result of its investigation, the National Transportation Safety Board makes recommendations to the National Highway Traffic Safety Administration. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Fatalities KW - Highway safety KW - Injuries KW - Loss of control KW - Rollover crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR1001.pdf UR - https://trid.trb.org/view/924886 ER - TY - RPRT AN - 01173100 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted June 2010 PY - 2010/06 SP - 38p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of June 2010. KW - Air transportation KW - Crash investigation KW - Crash prevention KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Traffic safety KW - Transportation safety UR - https://trid.trb.org/view/929207 ER - TY - RPRT AN - 01158530 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Explosion, Release, and Ignition of Natural Gas, Rancho Cordova, California, December 24, 2008 PY - 2010/05/18 SP - 16p AB - About 1:35 p.m. on December 24, 2008, an explosion and fire caused by a natural gas leak destroyed a house at 10708 Paiute Way in Rancho Cordova, California. One person suffered fatal injuries, and five other people, including one utility employee and one firefighter, were hospitalized as a result of the explosion. Two adjacent homes, one on either side, had severe damage, and several homes suffered minor damage. According to the Pacific Gas and Electric Company (PG&E), the property damage was $267,000. The National Transportation Safety Board determines that the probable cause of the December 24, 2008, release, ignition, and explosion of natural gas in Rancho Cordova, California, was the use of a section of unmarked and out-of-specification polyethylene pipe with inadequate wall thickness that allowed gas to leak from the mechanical coupling installed on September 21, 2006. Contributing to the accident was the 2-hour 47-minute delay in the arrival at the job site of a Pacific Gas and Electric Company crew that was properly trained and equipped to identify and classify outdoor leaks and to begin response activities to ensure the safety of the residents and public. KW - Crash causes KW - Crash investigation KW - Explosions KW - Natural gas pipelines KW - Pipeline accidents KW - Pipeline safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB1001.pdf UR - https://trid.trb.org/view/917940 ER - TY - RPRT AN - 01158525 AU - National Transportation Safety Board TI - Aircraft Accident Report: Loss of Thrust in Both Engines After Encountering a Flock of Birds and Subsequent Ditching on the Hudson River, US Airways Flight 1549, Airbus A320-214, N106US, Weehawken, New Jersey, January 15, 2009 PY - 2010/05/04 SP - 213p AB - This report describes the January 15, 2009, accident involving the ditching of US Airways flight 1549 on the Hudson River about 8.5 miles from LaGuardia Airport, New York City, after an almost complete loss of thrust in both engines following an encounter with a flock of birds. The 150 passengers, including a lap-held child, and 5 crewmembers evacuated the airplane by the forward and overwing exits. One flight attendant and four passengers were seriously injured, and the airplane was substantially damaged. Safety issues discussed in this report include in-flight engine diagnostics, engine bird-ingestion certification testing, emergency and abnormal checklist design, dual-engine failure and ditching training, training on the effects of flight envelope limitations on airplane response to pilot inputs, validation of operational procedures and requirements for airplane ditching certification, and wildlife hazard mitigation. The report also discusses survival-related issues, including passenger brace positions; slide/raft stowage; passenger immersion protection; life line usage; life vest stowage, retrieval, and donning; preflight safety briefings; and passenger education. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration, the U.S. Department of Agriculture, and the European Aviation Safety Agency. KW - Air transportation crashes KW - Aviation safety KW - Bird strikes KW - Crash causes KW - Crash investigation KW - Ditching KW - Hudson River UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1003.pdf UR - https://trid.trb.org/view/917904 ER - TY - RPRT AN - 01162854 AU - National Transportation Safety Board TI - Highway Accident Brief: Motorcoach Run Off Roadway and Rollover, Interstate 87, Near Westport, New York, August 28, 2006 PY - 2010/04/21 SP - 13p AB - About 6:40 p.m. daylight savings time, on Monday, August 28, 2006, a 2000 Motor Coach Industries, Inc. (MCI), 45-foot, 55-passenger motorcoach operated by Greyhound Lines, Inc. (Greyhound), transporting 52 passengers and the driver, was traveling northbound on Interstate 87 (I-87) near Westport, New York. The motorcoach had departed the Port Authority terminal in New York City about 1:00 p.m. and was en route to its final destination of Montreal, Quebec. The weather was partly cloudy and the roadway was dry. The motorcoach began descending a 5-percent grade, in the left lane at about 75 mph, and passed a tractor-semitrailer that was in the right lane. As the motorcoach descended the grade, its speed increased to 78 mph. The left-steer-axle tire of the motorcoach experienced a failure and sudden deflation. While the tractor-semitrailer was adjacent to the motorcoach in the right lane, the motorcoach departed the left lane, continued across the left shoulder, and struck the three-strand cable barrier. The motorcoach continued through the three-strand cable barrier and into the depressed earthen center median. The motorcoach began to rotate clockwise when the left rear wheels struck a large boulder, causing it to roll over 1.5 times before coming to rest on its roof. The driver and 4 passengers were killed; 48 passengers sustained injuries ranging from minor to serious. The National Transportation Safety Board determines that the probable cause of this accident was the failure of the left-steer-axle tire, due to an extended period of low-pressure operation, which resulted in overheating and tread separation, leading to loss of vehicle control. Contributing to the accident was the imbalanced brakes, which enhanced the vehicle’s counterclockwise rotation and loss of control when applied by the driver. Also contributing to the severity of passenger injuries was the lack of occupant protection standards for motorcoaches. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Fatalities KW - Highway safety KW - Injuries KW - Ran off road crashes KW - Rollover crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1002.pdf UR - https://trid.trb.org/view/920619 ER - TY - RPRT AN - 01162860 AU - National Transportation Safety Board TI - Highway Accident Brief: Median Crossover, Collision, and Fire, U.S. Highway 75, Sherman, Texas, September 20, 2004 PY - 2010/04/08 SP - 10p AB - On September 20, 2004, about 4:29 p.m. central daylight time, a 1999 Freightliner truck tractor, in combination with a 1997 Trailmobile dry van semitrailer, traveling northbound on U.S. Highway 75 (US 75), in the city of Sherman, Grayson County, Texas, crossed the median and collided with a 2000 Ford Expedition sport utility vehicle (SUV) and a 1990 Ford F150 pickup truck traveling southbound on the same road. A postaccident fire ensued. The Freightliner was driven by a 45-year-old man en route from Dallas, Texas, to Kansas City, Missouri. The weather was cloudy, and the roadway was dry. Tire marks from the accident scene, consistent with scuff marks, indicate that as the Freightliner tractor-semitrailer approached the Farm-to-Market 1417 overpass bridge at a speed of 65–70 mph, it veered leftward from the right lane, crossed the left lane, and entered the earthen median at an angle of approximately 20°. The tractor-semitrailer continued across the median and entered the southbound lanes, where it collided with the SUV and the pickup truck. The Freightliner and the SUV came to rest partially in the grass, just west of the southbound travel lanes; the ensuing fire engulfed both vehicles. The pickup truck came to rest in the southbound travel lanes. The driver and all four passengers in the SUV and the driver and four passengers in the pickup truck were killed. Two passengers in the pickup truck sustained serious injuries. The Freightliner driver received minor injuries. The National Transportation Safety Board determines that the probable cause of the September 20, 2004, median crossover accident near Sherman, Texas, was the Freightliner driver’s startle response consisting of a sudden and sharp over control maneuver to the left in an unnecessary reaction to vehicles that were traveling a safe distance ahead of the truck, caused either by the driver’s significant lack of sleep, which resulted in a brief period of sleep or attention loss while driving, or by the driver’s attempted or imminent use of a wireless device, which distracted him from his driving duties. Contributing to the severity of the accident was the use of a pickup truck cargo area bed to transport passengers despite its lack of any occupant restraint system. KW - Attention KW - Crash causes KW - Crash investigation KW - Distraction KW - Fatalities KW - Fatigue (Physiological condition) KW - Highway safety KW - Injuries KW - Traffic crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB1001.pdf UR - https://trid.trb.org/view/920625 ER - TY - RPRT AN - 01162850 AU - National Transportation Safety Board TI - Aircraft Accident Report: Runway Overrun During Rejected Takeoff, Global Exec Aviation, Bombardier Learjet 60, N999LJ Columbia, South Carolina, September 19, 2008 PY - 2010/04/06 SP - 116p AB - This report describes the September 19, 2008, accident involving a Bombardier Learjet Model 60 (Learjet 60), N999LJ, which overran runway 11 during a rejected takeoff at Columbia Metropolitan Airport, Columbia, South Carolina, while operating as a 14 Code of Federal Regulations Part 135 unscheduled passenger flight. The captain, the first officer, and two passengers were killed; two other passengers were seriously injured. The safety issues discussed in this report include the criticality of proper aircraft tire inflation; maintenance requirements and manual revisions for tire pressure check intervals; tire pressure monitoring systems; airplane thrust reverser system design deficiencies; inadequate system safety analyses by the Federal Aviation Administration (FAA) and Learjet; inadequate level of safety in the certification of changed aeronautical products; flight crew training for tire failure events; flight crew performance, including the captain’s action to initiate a rejected takeoff after V1, the captain’s experience, and crew resource management techniques; and considerations for tire certification criteria. Safety recommendations concerning these issues are addressed to the FAA. KW - Air transportation crashes KW - Aviation safety KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Runway overruns KW - Takeoff UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1002.pdf UR - https://trid.trb.org/view/920577 ER - TY - RPRT AN - 01158537 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. Air Carrier Operations, Calendar Year 2006 PY - 2010/04/05 SP - 63p AB - The National Transportation Safety Board’s Review of Aircraft Accident Data: U.S. Air Carrier Operations Calendar Year 2006 covers aircraft operated by U.S. air carriers under Title 14 Parts 121 and 135 of the Code of Federal Regulations (CFR). Air carriers are generally defined as operators that fly aircraft in revenue service. Data for the years 1997–2005 are included to provide a historical context for the 2006 statistics. Readers who prefer to view or manipulate tabular data may access the data set online at http://www.ntsb.gov/aviation/stats.htm. KW - Air transportation crashes KW - Airlines KW - Annual reviews KW - Aviation safety KW - Crash data KW - Statistics KW - United States UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARC10-01.pdf UR - https://trid.trb.org/view/917905 ER - TY - RPRT AN - 01154679 AU - National Transportation Safety Board TI - Aviation Safety Study: Introduction of Glass Cockpit Avionics into Light Aircraft PY - 2010/03/09 SP - 91p AB - This study used manufacturer records, aircraft investigation information, and a tailored subset of general aviation activity survey data to assess how the transition to electronic primary flight display (PFD) avionics has affected the safety of light aircraft. The study also evaluated the resources and requirements supporting the transition to this new technology. The results of this study suggest that, for the aircraft and time period studied, the introduction of glass cockpit PFDs has not yet resulted in the anticipated improvement in safety when compared to similar aircraft with conventional instruments. Advanced avionics and electronic displays can increase the safety potential of general aviation aircraft operations by providing pilots with more operational and safety-related information and functionality, but more effort is needed to ensure that pilots are prepared to realize that potential. The Federal Aviation Administration (FAA), manufacturers, aviation industry groups, and academia have an established history of collaboration through the FAA Industry Training Standards (FITS) program initiative for supporting aircraft model-specific and scenario-based training techniques that would teach pilots “higher-order thinking skills.” However, the FAA has changed the focus of the FITS initiative and has to date relied on manufacturers and commercial vendors to deliver the equipment-specific training originally envisioned for FITS. Adoption of uniform equipment-specific training elements by the FAA to ensure pilots have adequate knowledge of aircraft equipment operation and malfunctions, as well as improved reporting of equipment malfunctions and service difficulties, is likely to improve the safety of general aviation operations beyond those involving aircraft with glass cockpit displays. However, such actions are particularly important in order to achieve the potential safety benefits associated with advanced cockpit technologies in light aircraft. KW - Aviation safety KW - Avionics KW - Cockpits KW - General aviation KW - Glass KW - Primary flight displays KW - Small aircraft UR - https://www.faasafety.gov/files/events/EA/EA27/2013/EA2748590/NTSB_Safety_Study_-_Introduction_of_Glass_Cockpit_Avionics_in_Light_Aircraft_(SS-1001).pdf UR - https://trid.trb.org/view/915001 ER - TY - RPRT AN - 01152585 AU - National Transportation Safety Board TI - Marine Accident Brief: Allision of Recreational Boat with Push Boat Little Man II, Intracoastal Waterway near Ponte Vedra Beach, Florida, April 12, 2009 PY - 2010/02/24 SP - 12p AB - About 1915 eastern daylight time on Sunday, April 12, 2009, an unnamed 22.5-foot recreational boat carrying 14 persons allided with the Little Man II, a 25.9-foot push boat (a type of towboat) moored near Ponte Vedra Beach in St. Johns County, Florida. An hour earlier, the recreational boat had departed a marina/restaurant in St. Augustine, Florida, and was northbound in the Intracoastal Waterway (ICW) to a marina in Jacksonville Beach, Florida, a distance of about 30 miles. Five persons on the boat died at the accident scene. The remaining nine persons were injured, seven seriously. Parties to the National Transportation Safety Board (NTSB) investigation of the accident were the U.S. Coast Guard and the Florida Fish and Wildlife Conservation Commission (FWC). The FWC’s Division of Law Enforcement is responsible for enforcing the state’s boating safety laws in addition to protecting its fish and wildlife resources. The National Transportation Safety Board determines that the probable cause of the allision of the recreational boat with the push boat Little Man II was the inattention of the boat operators, most likely the result of alcohol impairment on the part of the regular operator and inexperience on the part of the designated operator. KW - Allisions KW - Crash causes KW - Crash investigation KW - Fatalities KW - Florida KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB1001.pdf UR - https://trid.trb.org/view/913559 ER - TY - RPRT AN - 01151294 AU - National Transportation Safety Board TI - Aircraft Accident Report: Loss of Control on Approach, Colgan Air, Inc.,Operating as Continental Connection Flight 3407, Bombardier DHC-8-400, N200WQ, Clarence Center, New York, February 12, 2009 PY - 2010/02/02 SP - 299p AB - This report discusses the accident involving a Colgan Air, Inc., Bombardier DHC-8-400, N200WQ, operating as Continental Connection flight 3407, which experienced a loss of control on an instrument approach to Buffalo-Niagara International Airport, Buffalo, New York, and crashed into a residence in Clarence Center, New York, about 5 nautical miles northeast of the airport. The safety issues discussed in this report focus on strategies to prevent flight crew monitoring failures, pilot professionalism, fatigue, remedial training, pilot training records, airspeed selection procedures, stall training, Federal Aviation Administration (FAA) oversight, flight operational quality assurance programs, use of personal portable electronic devices on the flight deck, the FAA’s use of safety alerts for operators to transmit safety-critical information, and weather information provided to pilots. Safety recommendations concerning these issues are addressed to the FAA. KW - Air transportation crashes KW - Approach KW - Aviation safety KW - Buffalo (New York) KW - Crash causes KW - Crash investigation KW - Loss of control UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR1001.pdf UR - https://trid.trb.org/view/913325 ER - TY - RPRT AN - 01152588 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Metrolink Train 111 With Union Pacific Train LOF65-12, Chatsworth, California, September 12, 2008 PY - 2010/01/21 SP - 83p AB - About 4:22 p.m., Pacific daylight time, on Friday, September 12, 2008, westbound Southern California Regional Rail Authority Metrolink train 111, consisting of one locomotive and three passenger cars, collided head-on with eastbound Union Pacific Railroad (UP) freight train LOF65–12 near Chatsworth, California. The Metrolink train derailed its locomotive and lead passenger car; the UP train derailed its 2 locomotives and 10 of its 17 cars. The force of the collision caused the locomotive of train 111 to telescope into the lead passenger coach by about 52 feet. The accident resulted in 25 fatalities, including the engineer of train 111. Emergency response agencies reported transporting 102 injured passengers to local hospitals. Damages were estimated to be in excess of $12 million. KW - California KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR1001.pdf UR - https://trid.trb.org/view/913360 ER - TY - RPRT AN - 01147288 AU - National Transportation Safety Board TI - Railroad Accident Brief: Roadway Workers Struck by Amtrak Acela Train 2154, Providence, Rhode Island, March 13, 2008 PY - 2009/12/15 SP - 6p AB - On March 13, 2008, about 1:11 p.m., eastbound Amtrak Acela train 2154 struck two roadway workers at milepost (MP) 186.1 on track 2 along Amtrak’s Northeast Corridor in Providence, Rhode Island. The train was traveling about 50 mph at the time of impact. One worker was killed and the other was seriously injured. A third worker sustained minor injuries moving out of the train’s path. The injured were transported to and treated at a local hospital. The roadway work group involved in the accident consisted of three Amtrak employees and an HNTB contract inspector. The Amtrak employees included a foreman and two trackmen, who had designated roles as watchman and vehicle driver for the day. The foreman, who was in charge of the work group, filled out the proper paperwork establishing the on-track safety protection to be used that day—foul time with extra flags at hot spots. Before beginning work, the foreman held a job briefing informing the work group of this information. Throughout the day, the foreman changed the method of on-track protection from foul time protection to train approach warning three times. However, he did not hold subsequent job briefings to inform the work group of the changes or the heightened awareness required for train approach warning protection. Therefore, at the time of the accident, the other work group members did not know that they lacked the foul time protection that had been established at the start of the workday, and that as a result they were poorly positioned to safely perform their duties, especially in hot spots. The National Transportation Safety Board determines that the probable cause of the March 13, 2008, accident involving a roadway work group that was struck by eastbound Amtrak Acela train 2154 in Providence, Rhode Island, was the foreman’s failure to communicate critical changes made to on-track safety protection and to utilize all assigned trackmen as watchmen while working in a hot spot. Contributing to the accident was the watchman’s failure to recognize that he was poorly positioned to perform his duties. KW - Acela Express KW - Amtrak KW - Crash causes KW - Crash investigation KW - Fatalities KW - Maintenance personnel KW - Railroad crashes KW - Railroad safety KW - Work zone safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0904.pdf UR - https://trid.trb.org/view/907071 ER - TY - RPRT AN - 01149511 AU - National Transportation Safety Board TI - Highway Accident Summary Report: Motorcoach Rollover on U.S. Highway 59 Near Victoria, Texas, January 2, 2008 PY - 2009/12/08 SP - 124p AB - On January 2, 2008, about 4:13 a.m., a 2005 Volvo 47-passenger motorcoach carrying 47 passengers was proceeding northbound on U.S. Highway 59 (U.S. 59) about 5 miles south of Victoria, Texas, when the motorcoach driver partially drifted off the right edge of the roadway. As a result of the driver making a series of oversteers in an attempt to stay on the roadway, the motorcoach rotated counterclockwise and overturned onto its right side. The motorcoach’s right rear struck a guardrail as the motorcoach slid on its right side approximately 112 feet before coming to rest across the roadway. Within 5 minutes, and before emergency responders arrived on scene, a 2001 Ford Ranger pickup truck also traveling northbound on U.S. 59 struck the underside of the motorcoach forward of the rear axle. As a result of the initial motorcoach rollover, 1 passenger was fatally injured, and 46 passengers and the driver received injuries ranging from minor to serious. The driver of the pickup truck sustained minor injuries when the pickup truck struck the undercarriage of the motorcoach. The National Transportation Safety Board determines that the probable cause of this accident was the driver’s falling asleep, which caused him to partially drift off the road, resulting in oversteer corrections when the driver regained awareness, and subsequent vehicle loss of control and overturn. Contributing to the severity of the unrestrained passengers’ injuries was their striking objects and other passengers inside the motorcoach, as well as the partial ejections that occurred when the motorcoach overturned during the accident. The investigation identified the following safety issues: the lack of federal oversight of passenger motor carrier leasing agreements and the registration and use of non-Federal Motor Vehicle Safety Standard-compliant, passenger-carrying vehicles in commercial motor carrier operations in the United States. The report also addresses continuing deficiencies in motor carrier operating authority issues, safety rating methodology, and the New Entrant Safety Assurance Program. As a result of its investigation, the National Transportation Safety Board makes recommendations to the U.S. Department of Transportation, the National Highway Traffic Safety Administration, the Federal Motor Carrier Safety Administration, the U.S. Customs and Border Protection Agency, the American Association of Motor Vehicle Administrators, the International Registration Plan, Inc., and the Commercial Vehicle Safety Alliance. The NTSB also reiterates two previously issued recommendations to the Federal Motor Carrier Safety Administration. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Fatalities KW - Highway safety KW - Motor carriers KW - Texas KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0903.pdf UR - https://trid.trb.org/view/908687 ER - TY - RPRT AN - 01146755 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Liberia-Registered Fruit Juice Carrier M/V Orange Sun with U.S.-Registered Dredge New York, Newark Bay, New Jersey, January 24, 2008 PY - 2009/12/02 SP - 51p AB - This report discusses the January 24, 2008, accident in which the fruit juice carrier M/V Orange Sun allided with a dredge, New York, while the ship was outbound in Newark Bay, New Jersey. As a result of the allision, the New York sustained about $6 million in damage, including salvage costs, and the Orange Sun about $330,000. About 100 gallons of mixed oil from the dredge’s machinery was released as a result of the accident. No one was injured. The safety issue identified in this accident was the actions of the Orange Sun crew and the pilot leading up to the allision. As a result of the investigation, one safety recommendation is issued to the Orange Sun’s operating company. KW - Allisions KW - Crash causes KW - Crash investigation KW - Marine safety KW - New Jersey KW - Newark Bay KW - Oil spills KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0903.pdf UR - https://trid.trb.org/view/906904 ER - TY - RPRT AN - 01150524 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted December 2009 PY - 2009/12 SP - 64p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of December 2009. KW - Aviation safety KW - Crash investigation KW - Highway safety KW - Prevention KW - Railroad safety KW - Recommendations KW - Transportation safety KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/913081 ER - TY - RPRT AN - 01145039 AU - National Transportation Safety Board TI - Highway Accident Brief: School Bus Bridge Override Following Collision With Passenger Vehicle, Interstate Highway 565 Transition Exit Ramp 19A, Huntsville, Alabama, November 20, 2006 PY - 2009/11/19 SP - 14p AB - On Monday, November 20, 2006, about 10:10 a.m. central standard time, a 2006 Integrated Conventional Corporation (IC) 71-passenger school bus, transporting 40 students from Lee High School to the Huntsville Center for Technology, was traveling westbound in the left lane of an elevated two-lane Interstate Highway 565 (I-565) transition ramp, in Huntsville, Alabama. A 1990 Toyota Celica, also traveling from Lee High School to the Huntsville Center for Technology, was in the left lane behind the school bus. According to witnesses, the Toyota moved to the right lane and accelerated in an attempt to pass the school bus. The driver of the Toyota stated that as he came alongside the school bus, his vehicle began "fishtailing" and became impossible to control. The Toyota veered to the left, striking the right front tire of the school bus. The vehicles remained in contact as they swerved to the left, and both vehicles struck a 32-inch-high cement bridge rail on the left side of the ramp. Physical evidence indicated that the school bus climbed and overrode the bridge rail. The school bus driver, who was not wearing his seat belt, was ejected from the bus onto the roadway. The bus continued along the top of the bridge rail for about 117 feet before rolling and falling 30 feet to a dirt and grass area beneath the ramp. The school bus landed on its front end, rotated clockwise, and came to rest upright on its wheels. Four students in the school bus were killed. The bus driver was seriously injured, and 33 students received minor-to-serious injuries. Three students were not injured. After striking the bridge rail, the Toyota continued along the ramp. It curved to the right and came to rest against the north bridge rail. The driver and his passenger were not injured. At the time of the accident, the roadway was dry, the visibility was 10 miles, the temperature was 39° F, and the wind was blowing from the north at 14 mph. The National Transportation Safety Board determines that the probable cause of the November 20, 2006, accident in Huntsville, Alabama, was a vehicle loss of control during a passing maneuver around a curve by the Toyota driver attempting to overtake the school bus prior to an impending exit both drivers intended to take. Contributing to the severity of the accident was the restricted trajectory of the school bus away from the bridge rail due to the presence of the Toyota, which resulted in the bus overriding the rail and falling 30 feet from the elevated highway access ramp to the ground. KW - Automobiles KW - Crash causes KW - Crash investigation KW - Fatalities KW - Highway bridges KW - Highway safety KW - Huntsville (Alabama) KW - Loss of control KW - Passing KW - School buses KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0901.pdf UR - https://trid.trb.org/view/905339 ER - TY - RPRT AN - 01146803 AU - National Transportation Safety Board TI - Marine Accident Summary: Engineroom Fire On Board U.S. Small Passenger Vessel Queen of the West, Columbia River, near Rufus, Oregon, April 8, 2008 PY - 2009/11/17 SP - 29p AB - This report discusses the April 8, 2008, engineroom fire on board the small passenger vessel Queen of the West. The vintage-styled paddlewheel vessel, carrying 124 overnight passengers and 53 crewmembers, was eastbound on the Columbia River near Rufus, Oregon, when the vessel’s automatic fire detection system alerted the crew to the fire. The crew was able to suppress the fire using the vessel’s fixed fire suppression system. The Queen of the West did not need to be emergency-evacuated. One crewmember was treated for mild hypothermia as a result of the accident. The Queen of the West sustained about $3.9 million in damage. The following safety issues were identified as a result of the accident investigation: importance of having a functioning automatic fire detection system and a fixed fire suppression system on small passenger vessels; and the inadequate requirements for small passenger vessels regarding out-of-water survival craft for passengers and crew. As a result of its investigation, the National Transportation Safety Board (NTSB) makes one new recommendation and reiterates a previous recommendation, both to the U.S. Coast Guard. KW - Crash causes KW - Crash investigation KW - Fire detection systems KW - Fires KW - Marine safety KW - Small ships UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0904.pdf UR - https://trid.trb.org/view/906456 ER - TY - RPRT AN - 01148566 AU - National Transportation Safety Board TI - Highway Accident Brief: School Bus Loss of Control and Rollover, Interstate 10, Near Milton, Florida, May 28, 2008 PY - 2009/11/12 SP - 7p AB - About 9:30 a.m. on Thursday May 28, 2008, a 2002 Bluebird/International 65-passenger school bus operated by the Okaloosa County School District, transporting 14 third-grade students, 3 adult passengers, and the 60-year-old bus driver on a school-sponsored field trip, was traveling westbound on Interstate 10 (I-10). Also known as Florida State Route 8 at the accident location, I-10 is a two-way, four-lane divided highway, approximately 10 miles east of Milton, Florida. The school bus had departed from the Walker Elementary School and was en route to the National Naval Aviation Museum in Pensacola, Florida. The school bus was traveling in the right traffic lane at the vehicle’s governed maximum speed of 55 mph when, for unknown reasons, the bus driver drifted partially into the left lane of I-10 westbound. At the same time, a 2002 Chevrolet Tahoe was traveling westbound in the left lane at a driver-estimated speed of 70–75 mph. As the Tahoe was passing the school bus, and the school bus drifted into the left lane, the Tahoe’s right-front bumper struck the left-rear bumper of the bus. The roadway is flat, and the posted speed limit is 70 mph at the accident location. As a result of the impact and difference in vehicle bumper heights, the right-front bumper of the Tahoe became snagged on the left-rear bumper corner of the school bus, and both vehicles remained in contact for approximately 17–18 feet. As a result of the impact from the rear by a vehicle traveling at a higher rate of speed, the school bus veered back into the right lane and dragged the Tahoe into the right lane, where the vehicle’s bumper then separated. The Tahoe slowed and continued forward onto the left shoulder and grass median of I-10, while the school bus passed the Tahoe and continued onto the left shoulder and grass median and began to yaw counterclockwise. Furrow marks in the center median indicate that, after the bus entered the median, it began to rotate clockwise as it reached the center of the median. After the front-left tire of the school bus began to plow into the earthen median, the bus overturned. Physical evidence at the scene indicated that the bus rolled over at least twice (720 degrees) before coming to final rest. In addition, the bus body separated from the chassis at a point just beyond the engine unit rearward. As a result of the accident, the lap/shoulder-belted school bus driver and one lap-belted student on the school bus sustained serious injuries; the three adult passengers and the 13 other students, all of whom were secured by lap belts, received minor or no injuries. The National Transportation Safety Board determines that the probable cause of the Milton, Florida, accident was the school bus driver’s failure, for undetermined reasons, to maintain her traffic lane, which resulted in the bus being struck from behind when it drifted into the left lane and into the path of an oncoming faster-moving vehicle. Injury severity was mitigated by the use of lap belts. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Driver errors KW - Highway safety KW - Injuries KW - Lane changing KW - Loss of control KW - Rollover crashes KW - School buses UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0903.pdf UR - https://trid.trb.org/view/908182 ER - TY - RPRT AN - 01145038 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Collision of Cargo Tank Truck and Automobile and Subsequent Fire, Upper Pittsgrove Township, New Jersey, July 1, 2009 PY - 2009/11/12 SP - 7p AB - On July 1, 2009, about 1:46 a.m., a 2002 Kenworth tractor pulling a 1989 Fruehauf MC-306 cargo tank semitrailer (the cargo tank truck) was traveling eastbound on U.S. Route 40 in Upper Pittsgrove Township, New Jersey, when it was struck by a 2002 Mitsubishi Diamante (the automobile) traveling northbound on Commissioners Pike. The automobile driver failed to obey a stop sign equipped with flashing red lights and collided with the external loading lines on the passenger side of the cargo tank truck. Loading line 4 was ruptured and about 13 gallons of gasoline were released as the automobile became wedged beneath the cargo tank truck and was dragged about 500 feet. A postcrash fire consumed the automobile, killing the driver; the cargo tank truck also was damaged. The Daretown Volunteer Fire Department arrived within 15 minutes and extinguished the fire. Property damage was about $27,000. At the time of the accident, it was dark, and the temperature was 67° F. There were light winds and clear skies. Rain had been observed in the hour before the collision; however, it was not a factor in the accident. The National Transportation Safety Board determines that the probable cause of the July 1, 2009, vehicle collision and fire in Upper Pittsgrove Township, New Jersey, was the failure of the automobile driver to obey a stop sign equipped with flashing red lights. Contributing to the severity of the accident was a fire that resulted from the release of gasoline from a cargo tank loading line that was ruptured during the collision. KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fires KW - Gasoline KW - Hazardous materials KW - Highway safety KW - Tank trucks KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB0901.pdf UR - https://trid.trb.org/view/905336 ER - TY - RPRT AN - 01144523 AU - National Transportation Safety Board TI - Railroad Accident Brief: Rail Grinder Derailment on Union Pacific Railroad, Baxter, California, November 9, 2006 PY - 2009/11/03 SP - 7p AB - About 11:00 a.m. on November 9, 2006, a Harsco Track Technologies (Harsco) rail grinder was moving on the Union Pacific Railroad (UP) when it derailed near Baxter, California. The rail grinder consisted of 2 modified locomotives and 11 specialized rail cars. Ten of the cars derailed. One UP conductor-pilot, one Harsco subcontractor cook, and eight Harsco employees, including one supervisor, were on board at the time of the accident. Two of the Harsco employees were killed. A fire broke out in the wreckage following the derailment. Monetary damage to the equipment and track was estimated to be $3.33 million. The National Transportation Safety Board determines that the probable cause of the November 9, 2006, derailment of the Harsco Track Technologies rail grinder was the failure of the braking system due to ineffective preaccident maintenance, inspections, and testing and the inappropriate brake recharging technique used by the A-end operator. A contributing factor was the failure of the Federal Railroad Administration to provide adequate safety oversight of rail grinders. KW - Crash causes KW - Crash investigation KW - Derailments KW - Grinders KW - Rail grinding KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0903.pdf UR - https://trid.trb.org/view/904335 ER - TY - RPRT AN - 01150517 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted November 2009 PY - 2009/11 SP - 86p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of November 2009. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Prevention KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/912906 ER - TY - RPRT AN - 01146338 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Run-Off-the-Bridge and Rollover, Sherman, Texas, August 8, 2008 PY - 2009/10/27 SP - 82p AB - About 12:45 a.m. on August 8, 2008, a 56-passenger motorcoach was northbound on U.S. Highway 75 when it was involved in a single-vehicle accident in Sherman, Texas. The motorcoach had left Houston, Texas, about 8:30 p.m. on August 7, 2008, with a driver and 55 passengers onboard, en route to Carthage, Missouri. Before the crash, the motorcoach was traveling in the right lane of the four-lane divided highway. As the motorcoach approached the Post Oak Creek near Sherman, its right steer axle tire failed. The motorcoach departed the roadway, overrode a 7-inch-high, 18-inch-wide concrete curb, and struck the metal bridge railing. After riding against the bridge railing for about 120 feet, the motorcoach went through the railing and off the bridge. It fell about 8 feet and slid on its right side before coming to rest on the inclined earthen bridge abutment adjacent to the creek. As a result of the accident, 17 motorcoach passengers died, the motorcoach driver received serious injuries, and 38 passengers received minor-to-serious injuries. The major safety issues identified in the accident investigation included the need for tire pressure monitoring systems on commercial vehicles; the need for criteria for the selection of bridge railing designs; the lack of oversight of the Federal commercial vehicle inspections delegated to the states; the lack of motorcoach occupant protection systems; and the deficiencies in Federal safety oversight of new entrant motor carriers. As a result of its investigation, the NTSB makes recommendations to the Federal Highway Administration, the Federal Motor Carrier Safety Administration (FMCSA), the National Highway Traffic Safety Administration (NHTSA), the American Association of State Highway and Transportation Officials, the American Association of Motor Vehicle Administrators, and Motor Coach Industries, Inc. The NTSB also reiterates previous recommendations to the FMCSA and NHTSA. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Fatalities KW - Highway safety KW - Injuries KW - Ran off road crashes KW - Rollover crashes KW - Sherman (Texas) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0902.pdf UR - https://trid.trb.org/view/905581 ER - TY - RPRT AN - 01146323 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash During Approach to Landing of Maryland State Police Aerospatiale SA365N1, N92MD, District Heights, Maryland, September 27, 2008 PY - 2009/10/27 SP - 89p AB - This report describes the circumstances of an accident involving an Aerospatiale SA365N1 that crashed on approach to landing during an emergency medical services flight operated by the Maryland State Police (MSP). The safety issues discussed include risk assessments, pilot performance and training, terrain awareness and warning systems, air traffic control deficiencies, MSP System Communications Center duty officer performance, and emergency response. Also discussed are patient transport decisions, flight recorder requirements, and Federal Aviation Administration (FAA) oversight. Safety recommendations concerning these issues are addressed to the FAA; the MSP; Prince George’s County, Maryland; all public helicopter emergency medical services operators, and six associations whose members are involved in search and rescue operations. KW - Air ambulances KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - District Heights (Maryland) KW - Emergency medical services KW - Landing UR - http://app.ntsb.gov/doclib/reports/2009/AAR0907.pdf UR - https://trid.trb.org/view/905621 ER - TY - RPRT AN - 01145044 AU - National Transportation Safety Board TI - Aircraft Accident Report: Loss of Control and Crash, Marlin Air Cessna Citation 550, N550BP, Milwaukee, Wisconsin, June 4, 2007 PY - 2009/10/14 SP - 116p AB - This report describes the circumstances of an accident involving a Cessna Citation 550, which impacted Lake Michigan shortly after departure. The safety issues discussed include pilot actions and coordination, the need for image recording equipment on airplanes not equipped with flight data recorders, autopilot panel design, control yoke wiring installations, identification of circuit breakers for use in emergencies, aural and visual alerts to pitch trim-in-motion, aileron trim power and sensitivity, human factors in airplane design, Federal Aviation Administration (FAA) appointment of check airmen, the scope of Regional Aviation Safety Inspection Program inspections, avenues for expressing safety concerns to Federal authorities, and the safety ramifications of operators’ financial health. Safety recommendations to the FAA and the American Hospital Association are included. KW - Air transportation crashes KW - Aviation safety KW - Cessna Citation aircraft KW - Crash causes KW - Crash investigation KW - Lake Michigan KW - Loss of control KW - Milwaukee (Wisconsin) UR - http://app.ntsb.gov/doclib/reports/2009/AAR0906.pdf UR - https://trid.trb.org/view/905337 ER - TY - RPRT AN - 01144483 AU - National Transportation Safety Board TI - Pipeline Accident Report: Rupture of Hazardous Liquid Pipeline With Release and Ignition of Propane, Carmichael, Mississippi, November 1, 2007 PY - 2009/10/14 SP - 65p AB - On November 1, 2007, at 10:35:02 a.m. central daylight time, a 12-inch-diameter pipeline segment operated by Dixie Pipeline Company was transporting liquid propane at about 1,405 pounds per square inch, gauge, when it ruptured in a rural area near Carmichael, Mississippi. The resulting gas cloud expanded over nearby homes and ignited, creating a large fireball that was heard and seen from miles away. About 10,253 barrels (430,626 gallons) of propane were released. As a result of the ensuing fire, two people were killed and seven people sustained minor injuries. Four houses were destroyed, and several others were damaged. About 71.4 acres of grassland and woodland were burned. Dixie Pipeline Company reported that property damage resulting from the accident, including the loss of product, was $3,377,247. The safety issues identified in this accident are the failure mechanisms and safety of low-frequency electric resistance welded pipe, the adequacy of Dixie Pipeline Company’s public education program, the adequacy of federal pipeline safety regulations and oversight exercised by the Pipeline and Hazardous Materials Safety Administration of pipeline operators’ public education and emergency responder outreach programs, and emergency communications in Clarke County, Mississippi. As a result of the investigation of this accident, the National Transportation Safety Board makes recommendations to the Pipeline and Hazardous Materials Safety Administration, the Dixie Pipeline Company, the American Petroleum Institute, and the Clarke County Board of Supervisors. KW - Crash causes KW - Crash investigation KW - Fires KW - Hazardous materials KW - Liquids KW - Pipeline accidents KW - Pipeline safety KW - Propane UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0901.pdf UR - https://trid.trb.org/view/904303 ER - TY - RPRT AN - 01150489 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted October 2009 PY - 2009/10 SP - 106p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of October 2009. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/912724 ER - TY - RPRT AN - 01142905 AU - National Transportation Safety Board TI - Marine Accident Report: Sinking of U.S. Fish Processing Vessel Alaska Ranger, Bering Sea, March 23, 2008 PY - 2009/09/30 SP - 93p AB - This report discusses the March 23, 2008, sinking of the U.S. fish processing vessel Alaska Ranger in the Bering Sea, 120 nautical miles west of Dutch Harbor, Alaska. The Alaska Ranger had left Dutch Harbor the previous day to fish on Petrel Bank, a fishing ground 500 nautical miles to the west. About 0230 on the morning of March 23, the crew discovered flooding in the vessel’s rudder room, and at 0246, the vessel broadcast a Mayday call. The U.S. Coast Guard immediately launched search and rescue operations. The crew evacuated the vessel before it sank sometime after 0430. The Coast Guard and the crew of another fishing vessel, the Alaska Warrior, rescued 42 of the 47 persons who had been on the Alaska Ranger. Five crewmembers died in the accident. The wreckage of the Alaska Ranger lies in 6,000 feet of water at the bottom of the Bering Sea and was not examined. The vessel’s estimated replacement value was $15 million. The NTSB participated fully in a Coast Guard Marine Board of Investigation convened immediately after the sinking. The NTSB’s investigation of the accident identified the following safety issues: the vessel’s movement astern, company operations, postaccident drug and alcohol testing, emergency response, implementation of the Coast Guard’s Alternate Compliance and Safety Agreement, and oversight of U.S. commercial fishing industry vessels. On the basis of its findings, the NTSB made recommendations to the Coast Guard, the National Marine Fisheries Service, the North Pacific Fishery Management Council, and Fishing Company of Alaska, Inc. KW - Bering Sea KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0905.pdf UR - https://trid.trb.org/view/903036 ER - TY - RPRT AN - 01142367 AU - National Transportation Safety Board TI - Highway Special Investigation Report: Pedal Misapplication in Heavy Vehicles PY - 2009/09/01 SP - 57p AB - In May 2005, the National Transportation Safety Board (NTSB) began its investigation of a school bus accident that occurred in Liberty, Missouri. During the course of the investigation, information was uncovered that suggested pedal misapplication as a factor in the accident—that is, depressing the accelerator instead of, or in addition to, the brake pedal. The NTSB subsequently investigated four additional accidents—in Falls Township and Newtown, Pennsylvania; Asbury Park, New Jersey; and Nanuet, New York—involving heavy vehicles in which pedal misapplication was determined to be a factor. Despite varying circumstances, these five accidents share common elements. In all five, the drivers either reported a loss of braking or were observed by vehicle occupants to be unsuccessfully attempting to stop the vehicles, though no evidence of braking system failure was found. Major safety issues identified by this special investigation of pedal misapplication in heavy vehicles include the need for brake transmission shift interlock systems; the need for increased analysis of pedal design configurations; the need for school bus drivers, in particular, to have annual refamiliarization training on all bus types that they might drive; the benefits of positive separation in transit areas to decrease the risks of unintended acceleration during loading and unloading activities; and the need for event data recorders in school buses and motorcoaches. As a result of this investigation, the NTSB makes recommendations to the National Highway Traffic Safety Administration, the National Association of State Directors of Pupil Transportation Services, and the National Association for Pupil Transportation. In addition, the NTSB reiterates and reclassifies two previously issued recommendations to the National Highway Traffic Safety Administration and reclassifies one previously issued recommendation to the Community Transportation Association of America. KW - Accelerators (Pedals) KW - Brake pedals KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Driving KW - Highway safety KW - School bus drivers KW - School buses UR - http://app.ntsb.gov/doclib/safetystudies/SIR0901.pdf UR - https://trid.trb.org/view/902468 ER - TY - RPRT AN - 01142495 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted September 2009 PY - 2009/09 SP - 92p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of September 2009. KW - Air transportation KW - Crash investigation KW - Crash prevention KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Transportation safety KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/902732 ER - TY - RPRT AN - 01139960 AU - National Transportation Safety Board TI - Highway Accident Brief: Tanker Truck Overturn and Fire Interstate 895 Southbound, Near Elkridge, Maryland, January 13, 2004 PY - 2009/07/30 SP - 10p AB - About 2:45 p.m. on January 13, 2004, a 2003 Freightliner truck tractor in combination with a 2000 Heil cargo tank semitrailer (tanker) was traveling southbound on Interstate 895 (I-895) near the city of Elkridge, in Howard County, Maryland. The vehicle was being operated by a driver traveling to Bethesda, Maryland, to deliver 8,800 gallons of premium grade gasoline. The weather was cloudy, and the roadway was dry. Tire scuff marks indicate that as the tanker approached an overpass (bridge) to Interstate 95 (I-95), it departed from the right traffic lane and went onto the adjacent shoulder. Scrape and gouge marks on the pavement, roadside barrier, and bridge rail further indicate that as the vehicle traveled along the shoulder, it collided with and mounted these roadside barriers before falling 30 feet over the bridge rail and onto the northbound traffic lanes and median of I-95. The vehicle’s speed prior to the accident most likely did not exceed 49 mph based on physical evidence and postaccident tests. An explosion and large fire ensued, and four vehicles traveling northbound on I-95 drove into the fire. After firefighters had extinguished the fire (see figure 3), they found five vehicles at final rest positions within the burned area of I-95: the accident tanker, a 2003 Freightliner tractor dry van semitrailer combination unit, a 1999 International tractor flatbed semitrailer combination unit, a 1998 Ford Crown Victoria sedan, and a 1987 Chevrolet pickup truck. The drivers of the accident tanker, the 2003 Freightliner dry van semitrailer, the Ford sedan, and the pickup truck sustained fatal injuries. The driver of the 1999 International tractor escaped uninjured from his burning vehicle. The National Transportation Safety Board determines that the probable cause of the January 13, 2004, accident in Elkridge, Maryland, was the failure of the tanker driver to maintain control of his vehicle for undetermined reasons. Contributing to the accident was the narrowed shoulder at the beginning of the overpass and the outdated design of this section of the roadway, including the flared concrete parapet and guardrail transition, which led the tanker to mount the parapet and vault the concrete safety shape barrier bridge rail so that the vehicle fell from the overpass onto the roadway below. KW - Crash causes KW - Crash investigation KW - Elkridge (Maryland) KW - Fatalities KW - Fire KW - Highway safety KW - Tank trucks KW - Traffic crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0901.pdf UR - https://trid.trb.org/view/899269 ER - TY - RPRT AN - 01140952 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash of Cessna 500, N113SH, Following an In-Flight Collision with Large Birds, Oklahoma City, Oklahoma, March 4, 2008 PY - 2009/07/28 SP - 68p AB - This report describes the crash of a Cessna 500 about 2 minutes after takeoff from Wiley Post Airport in Oklahoma City, Oklahoma. The airplane impacted one or more large birds, which likely damaged the airplane’s wing structure. The safety issues discussed include airframe certification standards for bird strikes, inadequate Federal Aviation Administration (FAA) enforcement of wildlife hazard assessment requirements for airports located near wildlife attractants, the lack of published information regarding aircraft operational strategies for pilots to minimize bird-strike damage to aircraft, and inadequate FAA detection of and intervention in improper charter operations. Safety recommendations concerning these issues are addressed to the FAA. KW - Air transportation crashes KW - Aviation safety KW - Bird strikes KW - Crash causes KW - Crash investigation KW - Wings (Aircraft) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0905.pdf UR - https://trid.trb.org/view/901226 ER - TY - RPRT AN - 01139904 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision Between Two Massachusetts Bay Transportation Authority Green Line Trains, Newton, Massachusetts, May 28, 2008 PY - 2009/07/14 SP - 46p AB - On May 28, 2008, about 5:51 p.m., eastern daylight time, westbound Massachusetts Bay Transportation Authority Green Line train 3667, traveling about 38 mph, struck the rear of westbound Green Line train 3681, which had stopped for a red signal. The accident occurred in Newton, Massachusetts, a suburb of Boston. Each train consisted of two light rail trolley cars and carried two crewmembers—a train operator at the front of the lead car and a trail operator in the second car. The operator of the striking train was killed; the other three crewmembers sustained minor injuries. An estimated 185 to 200 passengers were on the two trains at the time of the collision. Of these, four sustained minor injuries, and one was seriously injured. Total damage was estimated to be about $8.6 million. In the course of its investigation of this accident, the NTSB identified the following safety issues: lack of a positive train control system on the Massachusetts Bay Transportation Authority light rail system, lack of coordination between crewmembers on Massachusetts Bay Transportation Authority light rail trains with regard to signal indications, inadequate requirements for Massachusetts Bay Transportation Authority train operators to report possible signal malfunctions, and lack of screening of rail transit operators for possible obstructive sleep apnea. As a result of its investigation of this accident, the NTSB makes recommendations to the Federal Transit Administration, all U.S. rail transit agencies, and the Massachusetts Bay Transportation Authority. The National Transportation Safety Board also reiterates one safety recommendation to the Massachusetts Bay Transportation Authority. KW - Crash causes KW - Crash investigation KW - Light rail transit KW - Massachusetts Bay Transportation Authority KW - Newton (Massachusetts) KW - Positive train control KW - Transit crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0902.pdf UR - https://trid.trb.org/view/899270 ER - TY - RPRT AN - 01139266 AU - National Transportation Safety Board TI - Aircraft Accident Summary Report: Ground Fire Aboard Cargo Airplane, ABX Air Flight 1611, Boeing 767-200, N799AX, San Francisco, California, June 28, 2008 PY - 2009/06/30 SP - 73p AB - This report explains the June 28, 2008, accident involving a Boeing 767-200, N799AX, operated by ABX Air as a cargo flight. The airplane experienced a ground fire before engine startup. The captain and the first officer evacuated the airplane through the cockpit windows and were not injured, and the airplane was substantially damaged. The safety issues discussed in this report involve the conductivity and the aging of oxygen hoses, the FAA’s airworthiness directive process, the proximity of oxygen system components to electrical wiring, the electrical grounding of oxygen systems, the potential for passenger reading lights on transport-category airplanes to become an ignition source, additional smoke detector systems for cargo airplanes, and the effectiveness of ABX Air’s continuing analysis and surveillance program. Safety recommendations regarding these issues are addressed to the Federal Aviation Administration and to ABX Air. KW - Air transportation crashes KW - Aviation safety KW - Cargo aircraft KW - Crash causes KW - Crash investigation KW - Fires UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0904.pdf UR - https://trid.trb.org/view/898261 ER - TY - RPRT AN - 01135634 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data U.S. General Aviation, Calendar Year 2005 PY - 2009/05/26 SP - 66p AB - A total of 1,670 general aviation accidents occurred during calendar year 2005, involving 1,688 aircraft. The total number of general aviation accidents in 2005 was slightly higher than in 2004, with a 3% increase of 53 accidents. Of the total number of accidents, 321 were fatal, resulting in a total of 563 fatalities. The number of fatal general aviation accidents in 2005 increased 2% from calendar year 2004, and the total number of fatalities increased by 1%. The circumstances of these accidents and details related to the aircraft, pilots, and locations are presented throughout this review. KW - Air transportation crashes KW - Crash data KW - Fatalities KW - General aviation UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARG09-01.pdf UR - https://trid.trb.org/view/892822 ER - TY - RPRT AN - 01129615 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Run-Off-the-Road and Rollover, U.S. Route 163, Mexican Hat, Utah, January 6, 2008 PY - 2009/04/21 SP - 98p AB - About 8:02 p.m., mountain standard time, a 2007 Motor Coach Industries 56-passenger motorcoach with a driver and 52 passengers on board was traveling southbound, descending a 5.6-percent grade leading to a curve to the left, 1,800 feet north of milepost 29 on U.S. Route 163. After entering the curve, the motorcoach departed the right side of the roadway at a shallow angle, striking the guardrail with the right-rear wheel and lower coach body. The motorcoach traveled approximately 350 feet along the foreslope, with the right tires off the roadway. The back tires lost traction as the foreslope transitioned into the drainage ditch. The motorcoach rotated in a counterclockwise direction as it descended an embankment. The motorcoach overturned, struck several rocks in a drainage ditch bed at the bottom of the embankment, and came to rest on its wheels. During the 360-degree rollover sequence, the roof of the motorcoach separated from the body, and 50 of the 53 occupants were ejected. Nine passengers were fatally injured, and 43 passengers and the driver received injuries ranging from minor to serious. Major safety issues identified by this accident investigation include driver fatigue, excessive vehicle speed, hours-of-service violations, motor carrier trip planning, motorcoach occupant protection, and emergency medical notification and response with regard to large motorcoaches traveling on rural roads. As a result of its investigation, the Safety Board makes recommendations to the Federal Interagency Committee on Emergency Medical Services, the Utah Bureau of Emergency Medical Services, the Federal Highway Administration, the American Association of State Highway and Transportation Officials, the National Association of State Emergency Medical Services Officials, the American Bus Association, the United Motorcoach Association, and Arrow Stage Lines. The Safety Board also reiterates one previously issued recommendation to the Federal Motor Carrier Safety Administration. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Highway safety KW - Ran off road crashes KW - Rollover crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0901.pdf UR - https://trid.trb.org/view/889340 ER - TY - RPRT AN - 01129606 AU - National Transportation Safety Board TI - Aircraft Accident Report: In-Flight Left Engine Fire, American Airlines Flight 1400, McDonnell Douglas DC-9-82, N454AA, St. Louis, Missouri, September 28, 2007 PY - 2009/04/07 SP - 375p AB - This report explains the September 28, 2007, accident involving a McDonnell Douglas DC-9-82, N454AA, operated as American Airlines flight 1400. The airplane experienced an in-flight engine fire during departure climb from Lambert St. Louis International Airport, St. Louis, Missouri, and the flight crew conducted an emergency landing. The safety issues discussed in this report relate to the following: characteristics of the “Air Turbine Starter Valve (ATSV) Open” light; emergency task allocation guidance; guidance and training on the interrelationship between pneumatic crossfeed valves and engine fire handles; multiple simultaneous emergencies training; guidance on evacuation preparation on the ground; guidance and training on communications between flight and cabin crews during emergency and unusual situations; ATSV air filter replacement intervals; and American Airlines’ Continuing Analysis and Surveillance System. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration and American Airlines. KW - Air transportation crashes KW - Aircraft KW - Crash causes KW - Crash investigation KW - Fire causes KW - Fires UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0903.pdf UR - https://trid.trb.org/view/889344 ER - TY - RPRT AN - 01127483 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Bahamas-Registered Tankship M/T Axel Spirit with Ambrose Light, Entrance to New York Harbor, November 3, 2007 PY - 2009/04/07 SP - 47p AB - This report discusses the November 3, 2007, accident in which the tankship M/T Axel Spirit allided with Ambrose Light, an aid to navigation, at the entrance to New York Harbor. The impact left a 60-foot-long indentation and scrapes along the starboard side hull of the vessel and damaged Ambrose Light beyond repair. No injuries or pollution resulted from the accident. The National Transportation Safety Board determines that the probable cause of the allision of the Axel Spirit with Ambrose Light was the master’s failure to use all available resources to determine the vessel’s position and course in the transit past Ambrose Light and to adequately communicate his intentions and expectations to the bridge team, which therefore prevented the bridge team from appropriately supporting the master. The Safety Board’s investigation identified the following safety issues: inadequate planning for the transit past Ambrose Light, inadequate bridge team communication during the approach to Ambrose Light, and failure to promptly report the allision and test for alcohol. KW - Aids to navigation KW - Allisions KW - Crash causes KW - Crash investigation KW - Marine safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0902.pdf UR - https://trid.trb.org/view/887947 ER - TY - RPRT AN - 01138286 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted April 2009 PY - 2009/04 SP - 58p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of April 2009. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Safety KW - Transportation safety KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/898348 ER - TY - RPRT AN - 01127485 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Amtrak Passenger Train 371 and Norfolk Southern Railway Company Freight Train 23M, Chicago, Illinois, November 30, 2007 PY - 2009/03/31 SP - 46p AB - On Friday, November 30, 2007, Amtrak (National Railroad Passenger Corporation) passenger train 371, consisting of one locomotive and three passenger cars, struck the rear of a standing Norfolk Southern Railway Company freight train near Chicago, Illinois. The forward portion of the Amtrak locomotive came to rest on top of a container on the rear car of the freight train. Sixty-six passengers and five crewmembers were transported to hospitals; two passengers and one crewmember were subsequently admitted. The weather was clear, and the temperature was 30º F. Estimated damage was $1,299,000. As a result of its investigation of this accident, the Safety Board identified the following safety issues: wayside signal indication training and proficiency programs, crewmember communication and action in response to operating concerns, and inadequate locomotive cab emergency egress and rescue access. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Federal Railroad Administration, Amtrak, the Association of American Railroads, the American Short Line and Regional Railroad Association, the Brotherhood of Locomotive Engineers and Trainmen, the United Transportation Union, and the American Public Transportation Association. KW - Chicago (Illinois) KW - Communication KW - Crash causes KW - Crash investigation KW - Emergency exits KW - Railroad crashes KW - Training KW - Wayside signals UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0901.pdf UR - https://trid.trb.org/view/887913 ER - TY - RPRT AN - 01128917 AU - National Transportation Safety Board TI - Railroad Accident Brief: Passenger Fatality on Long Island Rail Road, Queens, New York, August 5, 2006 PY - 2009/03/19 SP - 8p AB - On August 5, 2006, about 3:53 p.m., a 5-foot 6-inch, 110-pound, 18-year-old female passenger exiting a Long Island Rail Road (LIRR) commuter train at Woodside station in Queens, New York, fell through a 7 7/8-inch horizontal gap between the rail car and the station platform. After falling through the gap to track level beneath the platform, she did not follow instructions from the train conductor and her friends to remain still and wait to be rescued. Instead, the woman crawled under the platform and into the path of an oncoming passenger train. She sustained fatal injuries. Toxicology testing showed that her blood alcohol concentration (BAC) was 0.23 gram percent. The weather at the time of the accident was sunny, clear, and warm. The National Transportation Safety Board determines that the probable cause of the passenger fatality on August 5, 2006, at the Long Island Rail Road Woodside station in Queens, New York, was the passenger falling through a gap between the rail car and the platform while attempting to disembark the train, not following instructions from the train conductor to remain still until help arrived, and then crawling under the platform and into the path of a moving train on the opposite side of the platform. Contributing to the accident was the passenger’s alcohol-impaired condition. KW - Blood alcohol levels KW - Crash causes KW - Crash investigation KW - Fatalities KW - Passengers KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0901.pdf UR - https://trid.trb.org/view/887995 ER - TY - RPRT AN - 01126499 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. Air Carrier Operations, Calendar Year 2005 PY - 2009/03/09 SP - 68p AB - This report covers aircraft operated by U.S. air carriers under Title 14 Parts 121 and 135 of the Code of Federal Regulations (CFR). Air carriers are generally defined as operators that fly aircraft in revenue service. Data for the years 1996–2004 are included to provide an historical context for the 2005 statistics. Much of the information in this review is presented in graphs and tables. Readers who prefer to view or manipulate tabular data may access the data set online at http://www.ntsb.gov/aviation/stats.htm. KW - Air transportation crashes KW - Aircraft operations KW - Airlines KW - Annual reviews KW - Crash data UR - http://app.ntsb.gov/doclib/reports/2009/ARC0901.pdf UR - https://trid.trb.org/view/887437 ER - TY - RPRT AN - 01135231 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted March 2009 PY - 2009/03 SP - 30p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of March 2009. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Multimodal transportation KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/894580 ER - TY - RPRT AN - 01128936 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Hong Kong-Registered Containership M/V Cosco Busan with the Delta Tower of the San Francisco–Oakland Bay Bridge, San Francisco, California, November 7, 2007 PY - 2009/02/18 SP - 161p AB - On November 7, 2007, the Hong Kong-registered, 901-foot-long containership M/V Cosco Busan allided with the fendering system at the base of the Delta tower of the San Francisco–Oakland Bay Bridge. Contact with the bridge tower created a 212-foot-long by 10-foot-high by 8-foot-deep gash in the forward port side of the ship and breached the Nos. 3 and 4 port fuel tanks and the No. 2 port ballast tank. As a result of the breached fuel tanks, about 53,500 gallons of fuel oil were released into San Francisco Bay. No injuries or fatalities resulted from the accident, but the fuel spill contaminated about 26 miles of shoreline, killed more than 2,500 birds of about 50 species, temporarily closed a fishery on the bay, and delayed the start of the crab-fishing season. Total monetary damages were estimated to be $2.1 million for the ship, $1.5 million for the bridge, and more than $70 million for environmental cleanup. The safety issues identified during this accident investigation include medical oversight of the Cosco Busan pilot, medical oversight of mariners in general, guidance for vessel traffic service operators in exercising authority to manage traffic, procedures for improving the assessment of oil spills in California waters; and training and oversight of the Cosco Busan crew. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the U.S. Coast Guard, the American Pilots’ Association, and Fleet Management Ltd. KW - Allisions KW - Crash causes KW - Crash investigation KW - Environmental impacts KW - Oil spills KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0901.pdf UR - https://trid.trb.org/view/888911 ER - TY - RPRT AN - 01122005 AU - National Transportation Safety Board TI - Aircraft Accident Report: Midair Collision of Electronic News Gathering Helicopters, KTVK-TV, Eurocopter AS350B2, N613TV, and U.S. Helicopters, Inc., Eurocopter AS350B2, N215TV, Phoenix, Arizona, July 27, 2007 PY - 2009/01/28 SP - 66p AB - This report explains the accident involving two electronic news gathering (ENG) helicopters, N613TV and N215TV, that collided in midair while maneuvering in Phoenix, Arizona. The Eurocopter AS350B2 helicopters, from local channels 3 and 15, had been covering a police pursuit. N613TV, the channel 3 helicopter, was operated by KTVK-TV, and N215TV, the channel 15 helicopter, was operated by U.S. Helicopters, Inc., under contract to KNXV-TV. The safety issues discussed in this report focus on the limitations associated with the primary method of separation used during ENG operations; methods for improving an ENG pilot’s awareness of other helicopters operating in the same area; and the need for (1) meetings of Federal Aviation Administration (FAA) and ENG personnel to discuss operational procedures and manage risk, (2) ENG best practices guidelines, and (3) flight recorder systems for smaller aircraft. Safety recommendations concerning these issues are addressed to the FAA. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Electronic news gathering KW - Helicopter pilots KW - Helicopters KW - Midair crashes KW - Phoenix (Arizona) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0902.pdf UR - https://trid.trb.org/view/884096 ER - TY - RPRT AN - 01122003 AU - National Transportation Safety Board TI - Aircraft Accident Summary Report: In-flight Fire, Emergency Descent, and Crash in a Residential Area, Cessna 310R, N501N, Sanford, Florida, July 10, 2007 PY - 2009/01/28 SP - 35p AB - This report explains the July 10, 2007, accident involving a Cessna 310R, N501N, operated by the National Association for Stock Car Auto Racing corporate aviation division as a personal flight. The airplane crashed while performing an emergency diversion to Orlando Sanford International Airport, Orlando, Florida, after an in-flight fire. The flight had been released despite a known unresolved maintenance discrepancy. Safety issues discussed in this report relate to the resetting of circuit breakers, the inspection and maintenance of electrical systems in general aviation aircraft, and the establishment of safety management systems in general aviation corporate operations. Safety recommendations regarding these issues are addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Electrical systems KW - Fires KW - General aviation KW - General aviation aircraft KW - Maintenance UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0901.pdf UR - https://trid.trb.org/view/884000 ER - TY - RPRT AN - 01124470 AU - National Transportation Safety Board TI - Special Investigation Report: Mobile Acetylene Trailer Accidents: Fire During Unloading in Dallas, Texas, July 25, 2007; Fire During Unloading in The Woodlands, Texas, August 7, 2007; and Overturn and Fire in East New Orleans, Louisiana, October 20, 2007 PY - 2009/01/13/Special Investigation Report SP - 38p AB - The National Transportation Safety Board investigated three accidents that involved highway vehicles transporting bulk quantities of acetylene gas that occurred in 2007 and reviewed reports of a 2008 overturn accident of another vehicle. The vehicles, called mobile acetylene trailers, carried up to 225 cylinders that were connected by a manifold system and filled with acetylene. Two of the accidents occurred as the vehicles overturned on public highways, and two of the accidents occurred while the vehicles were being prepared for unloading. In the two overturn accidents, cylinders were ejected from the trailers and damaged, releasing acetylene, which ignited. In one unloading accident, the fire on the initial trailer spread to cylinders on an adjacent trailer; in the other, the fire also spread to nearby buildings and vehicles. The failures of the cylinders on these trailers and the resultant damage raised concerns about the accident protection provided by these vehicles, the adequacy of the minimum safety standards and procedures applicable to unloading these vehicles, and the adequacy of fire suppression systems at loading and unloading facilities. The safety issues discussed in this report are adequacy of mobile acetylene trailer design for protecting cylinders during transport, effectiveness and safety of unloading procedures for mobile acetylene trailers, and adequacy of fire suppression systems at mobile acetylene trailer loading and unloading facilities. As a result of this special investigation, the Safety Board makes safety recommendations to the Pipeline and Hazardous Materials Safety Administration and the Compressed Gas Association. KW - Acetylene KW - Circular cylinders (Geometry) KW - Crash investigation KW - Fires KW - Gas cylinders KW - Highway safety KW - Loading and unloading KW - Rollover crashes KW - Traffic safety KW - Trailers UR - http://app.ntsb.gov/doclib/safetystudies/SIR0901.pdf UR - https://trid.trb.org/view/885641 ER - TY - RPRT AN - 01138314 AU - National Transportation Safety Board TI - Highway Accident Reports PY - 2009 SP - v.p. AB - This ongoing subscription contains Transportation Accident Reports: Highway. The subscription offers reviews of investigations of selected highway accidents conducted by the National Transportation Safety Board. The Highway Accident Reports present in narrative form the Board's factual findings and analysis leading to a probable cause. There are approximately 4 reports per year. KW - Crash causes KW - Crash data KW - Crash investigation KW - Crash reports KW - Highway safety KW - Reports KW - Traffic crashes UR - https://trid.trb.org/view/898317 ER - TY - RPRT AN - 01138235 AU - National Transportation Safety Board TI - Pipeline Accident Reports PY - 2009 SP - v.p. AB - This ongoing subscription contains Transportation Accident Reports: Pipeline. The subscription offers reviews of investigations of selected pipeline accidents conducted by the National Transportation Safety Board. The Pipeline Accident Reports present in narrative form the Board's factual findings and analysis leading to a probable cause. There are approximately 4 reports per year. KW - Crash investigation KW - Crash reports KW - Crashes KW - Pipeline transportation KW - Pipelines KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/898356 ER - TY - RPRT AN - 01138229 AU - National Transportation Safety Board TI - Transportation Safety Recommendations PY - 2009 SP - v.p. AB - This ongoing subscription contains the Transportation Safety Recommendations reports on the Board's safety oversight and accident prevention activities. The safety reports provide information on significant transportation problems, issues, and activities KW - Crash prevention KW - Recommendations KW - Safety and security KW - Transportation KW - Transportation safety UR - https://trid.trb.org/view/898413 ER - TY - RPRT AN - 01138186 AU - National Transportation Safety Board TI - Marine Accident Reports PY - 2009 SP - v.p. AB - This ongoing subscription contains Transportation Accident Reports: Marine, which reviews investigations of selected marine accidents conducted by the National Transportation Safety Board. The marine accident reports present in narrative form the board's factual findings and analysis leading to a probable cause. There are an average of 10 reports per year. KW - Cargo ships KW - Crash causes KW - Crash reports KW - Crashes KW - Marine safety KW - Ships KW - Vessel operations KW - Water transportation crashes UR - https://trid.trb.org/view/898344 ER - TY - RPRT AN - 01123436 AU - National Transportation Safety Board TI - Railroad Accident Brief: Union Pacific Railroad Yard Switching Operations Fatality, Pajaro, California, October 13, 2006 PY - 2008/12/05 SP - 5p AB - On October 13, 2006, at 9:20 a.m., a Union Pacific Railroad (UP) switching brakeman was struck and killed by three coupled railroad cars at the UP’s Watsonville Junction Yard in Pajaro, California. The brakeman had been assigned to a two-person crew (one brakeman, one conductor) designated as LRQ42R-13, which was a regular weekday assignment. Their assignment was to switch railroad cars using a remote-controlled locomotive. This crew was the only one working in the yard. The conductor was using an Operator Control Unit (OCU) to remotely control a locomotive that was used to switch railroad cars onto various yard tracks. The brakeman was to (1) ensure that the car couplings were successfully completed, (2) set the hand brakes, as needed, and (3) connect the air hoses. The two men started switching cars about 8:00 a.m.; their first two switching operations of the day were uneventful. During the third switching operation, three railroad cars were to be switched on the south end of the yard. After the locomotive and the three coupled railroad cars were moving about 9 mph, the conductor lifted an uncoupling lever that uncoupled the cars from the locomotive and allowed the cars to roll freely onto track 4 at 9 mph, which was 6 mph faster than the maximum permissible speed for this release of free-rolling cars. The locomotive’s event recorder indicated that the brakeman’s OCU transmitted a tilt warning at 9:20 a.m. One second later, the OCU transmitted an emergency brake command. The tilt warning continued for 4 more seconds, and then the OCU transmitted an automated “man down.” The conductor said that he and the brakeman had discussed the operation by radio before the accident. He said that he had last seen the brakeman standing on the access road between tracks 2 and 4 about 200 to 300 feet north of the lead car. (The yard did not have a track 3.) The National Transportation Safety Board determines that the probable cause of the Union Pacific Railroad brakeman being struck and killed on October 13, 2006, in Pajaro, California, was the brakeman’s decision to board moving equipment. Contributing to the accident was the crew’s failure to properly follow the Union Pacific Railroad’s speed restrictions when switching cars. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Fatalities KW - Railroad crashes KW - Railroad safety KW - Speed KW - Switches (Railroads) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0807.pdf UR - https://trid.trb.org/view/884397 ER - TY - RPRT AN - 01121713 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Natural Gas Distribution Line Break and Subsequent Explosion and Fire, Plum Borough, Pennsylvania, March 5, 2008 PY - 2008/11/21 SP - 6p AB - On March 5, 2008, about 1:39 p.m., a natural gas explosion destroyed a residence at 171 Mardi Gras Drive in Plum Borough, Pennsylvania, killing a man and seriously injuring a 4-year-old girl. Two other houses were destroyed, and 11 houses were damaged. Property damage and losses were $1,000,000. The National Transportation Safety Board determines that the probable cause of the leak, explosion, and fire in Plum Borough, Pennsylvania, on March 5, 2008, was excavation damage to the 2-inch natural gas distribution pipeline that stripped the pipe’s protective coating and made the pipe susceptible to corrosion and failure. KW - Crash causes KW - Crash investigation KW - Explosions KW - Fatalities KW - Fires KW - Injuries KW - Leakage KW - Natural gas pipelines KW - Pipeline accidents KW - Pipeline safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB0801.pdf UR - https://trid.trb.org/view/880463 ER - TY - RPRT AN - 01118672 AU - National Transportation Safety Board TI - Highway Accident Report: Collapse of I-35W Highway Bridge Minneapolis, Minnesota, August 1, 2007 PY - 2008/11/14 SP - 178p AB - About 6:05 p.m. central daylight time on Wednesday, August 1, 2007, the eight-lane, 1,907-foot-long I-35W highway bridge over the Mississippi River in Minneapolis, Minnesota, experienced a catastrophic failure in the main span of the deck truss. As a result, 1,000 feet of the deck truss collapsed, with about 456 feet of the main span falling 108 feet into the 15-foot-deep river. A total of 111 vehicles were on the portion of the bridge that collapsed. Of these, 17 were recovered from the water. As a result of the bridge collapse, 13 people died, and 145 people were injured. On the day of the collapse, roadway work was underway on the I-35W bridge, and four of the eight travel lanes (two outside lanes northbound and two inside lanes southbound) were closed to traffic. In the early afternoon, construction equipment and construction aggregates (sand and gravel for making concrete) were delivered and positioned in the two closed inside southbound lanes. The equipment and aggregates, which were being staged for a concrete pour of the southbound lanes that was to begin about 7:00 p.m., were positioned toward the south end of the center section of the deck truss portion of the bridge and were in place by about 2:30 p.m. About 6:05 p.m., a motion-activated surveillance video camera at the Lower St. Anthony Falls Lock and Dam, just west of the I-35W bridge, recorded a portion of the collapse sequence. The video showed the bridge center span separating from the rest of the bridge and falling into the river. Major safety issues identified in this investigation include insufficient bridge design firm quality control procedures for designing bridges, and insufficient Federal and State procedures for reviewing and approving bridge design plans and calculations; lack of guidance for bridge owners with regard to the placement of construction loads on bridges during repair or maintenance activities; exclusion of gusset plates in bridge load rating guidance; lack of inspection guidance for conditions of gusset plate distortion; and inadequate use of technologies for accurately assessing the condition of gusset plates on deck truss bridges. As a result of this accident investigation, the Safety Board makes recommendations to the Federal Highway Administration (FHWA) and the American Association of State Highway and Transportation Officials. One safety recommendation resulting from this investigation was issued to the FHWA in January 2008. KW - Collapse KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Highway bridges KW - Highway factors in crashes KW - Highway safety KW - Minneapolis (Minnesota) KW - Minneapolis Bridge Collapse, 2007 UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0803.pdf UR - https://trid.trb.org/view/877787 ER - TY - RPRT AN - 01121710 AU - National Transportation Safety Board TI - Marine Accident Report: Grounding of U.S. Passenger Vessel Empress of the North, Intersection of Lynn Canal and Icy Strait, Southeast Alaska, May 14, 2007 PY - 2008/11/04 SP - 121p AB - This report discusses the May 14, 2007, accident in which the passenger vessel Empress of the North grounded on Rocky Island, about 20 miles southwest of Juneau. The vessel was carrying 206 passengers and 75 crewmembers on a cruise through Alaska’s Inland Passage. The junior third mate, a newly licensed officer, was on his first navigation watch at the time of the accident. The U.S. Coast Guard and good Samaritan vessels evacuated passengers and crewmembers and transported them back to Juneau. No injuries or pollution resulted from the accident. The cost of repairing the vessel and returning it to service was estimated at $4.8 million. The National Transportation Safety Board identified the following safety issues as a result of its accident investigation: the master’s decision to put an inexperienced third mate on watch without supervision or guidance; the junior third mate’s actions; watchkeeping procedures; documentation deficiencies; and malfunctioning lifesaving devices. As a result of its investigation, the Safety Board made recommendations to the U.S. state and Federal maritime academies and to the Passenger Vessel Association. Earlier recommendations were made to the Coast Guard. KW - Alaska KW - Crash causes KW - Crash investigation KW - Experience (Personnel) KW - Groundings (Maritime crashes) KW - Lifesaving KW - Rescue equipment KW - Watchkeeping KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0802.pdf UR - https://trid.trb.org/view/880461 ER - TY - RPRT AN - 01115473 AU - National Transportation Safety Board TI - Railroad Accident Brief: Derailment of CSX Transportation Train No. Q39010, Oneida, New York, March 12, 2007 PY - 2008/09/30 SP - 13p AB - On Monday, March 12, 2007, about 6:58 a.m., CSX Transportation (CSX) train No. Q39010, a mixed freight train, derailed near Oneida, New York. The train was en route from Buffalo, New York, to Selkirk, New York. At the time of the derailment, the train was traveling about 47 mph. The train consisted of 3 locomotives and 78 cars. Twenty-nine cars derailed. Six tank cars were breached, including four carrying liquefied petroleum gas, one carrying toluene, and one carrying ferric chloride. An explosion and fire followed that led local emergency response officials to close two elementary schools and evacuate a 1-mile area around the derailment site. Four firefighters were taken to a hospital for observation as a precaution because they had stepped in a pool of ferric chloride. There were no fatalities. Estimated damages and environmental cleanup costs were $6.73 million. The National Transportation Safety Board determines that the probable cause of the March 12, 2007, derailment of CSX train No. Q39010 and subsequent release of hazardous material near Oneida, New York, was the failure of the rail from an undetected detail fracture that initiated from an area of shelling on the rail. KW - Crash causes KW - Crash investigation KW - Defects KW - Derailments KW - Hazardous materials KW - Oneida (New York) KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0805.pdf UR - https://trid.trb.org/view/873905 ER - TY - RPRT AN - 01121755 AU - National Transportation Safety Board TI - Highway Accident Report: Truck-Tractor Semitrailer Rollover and Motorcoach Collision With Overturned Truck, Interstate Highway 94, Near Osseo, Wisconsin, October 16, 2005 PY - 2008/09/16 SP - 114p AB - On October 16, 2005, an accident comprising two events occurred on Interstate Highway 94 (I-94) near Osseo, Wisconsin. The first event was the rollover of a truck-tractor semitrailer combination unit. The second event occurred when a motorcoach collided with the wreckage from the first event. About 7:30 p.m. on October 15, 2005, a truck driver departed Munster, Indiana, on a trip to Minneapolis, Minnesota, driving a truck-tractor semitrailer operated by Whole Foods Market, Inc. At 1:58 a.m., the combination unit was traveling westbound on I-94 near milepost 85, when it departed the right-hand travel lane and paved shoulder. The unit left the roadway and entered the earthen, sloped roadside. The driver steered to the left, and the combination unit reentered the pavement and overturned onto its right side, so that it blocked both westbound lanes and shoulders of I-94. About 3 hours before, a group of marching band members from Chippewa High School left the University of Wisconsin to travel back to Chippewa Falls, Wisconsin, in four motorcoaches. The lead vehicle, a 55-passenger motorcoach owned by Chippewa Trails, Inc., was traveling westbound in the right-hand lane of I-94 when it collided with the overturned combination unit about 1:59 a.m. The motorcoach driver and four passengers were fatally injured. Thirty-five passengers received minor-to-serious injuries. The truck driver received minor injuries. Major safety issues identified in this report include operator fatigue, fatigue technologies and countermeasures, and collision warning systems. As a result of this accident investigation, the Safety Board makes recommendations to the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration (NHTSA), and Whole Foods Market, Inc. The Safety Board also reiterates two recommendations to NHTSA. KW - Bus crashes KW - Bus drivers KW - Countermeasures KW - Crash analysis KW - Crash avoidance systems KW - Crash causes KW - Crash investigation KW - Fatalities KW - Fatigue (Physiological condition) KW - Highway safety KW - Injuries KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers KW - Trucking safety KW - Warning systems UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0802.pdf UR - https://trid.trb.org/view/880457 ER - TY - RPRT AN - 01121737 AU - National Transportation Safety Board TI - Aircraft Accident Summary Report: Crash of Skydive Quantum Leap, de Havilland DHC-6-100, N203E, Sullivan, Missouri, July 29, 2006 PY - 2008/09/16 SP - 32p AB - This report explains the July 29, 2006, accident involving a de Havilland DHC-6-100, N203E, registered to Adventure Aviation, LLC, and operated by Skydive Quantum Leap as a local parachute operation flight. The aircraft crashed into trees and terrain after takeoff from Sullivan Regional Airport, near Sullivan, Missouri. The safety issues discussed in this report relate to the inadequate protection provided by single-point restraints for parachutists. Included are safety recommendations addressed to the Federal Aviation Administration and the United States Parachute Association regarding this issue. KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Parachutes KW - Protection KW - Restraint systems UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0803.pdf UR - https://trid.trb.org/view/880453 ER - TY - RPRT AN - 01121723 AU - National Transportation Safety Board TI - Special Investigation Report: Special Investigation Report on the Safety of Parachute Jump Operations PY - 2008/09/16 SP - 64p AB - This special investigation report describes the results of a National Transportation Safety Board review of 32 accidents that involved parachute jump (“or skydiving”) operations and that occurred between 1980 and 2008. The report identifies the following recurring safety issues: inadequate aircraft inspection and maintenance; pilot performance deficiencies in basic airmanship tasks, such as preflight inspections, weight and balance calculations, and emergency and recovery procedures; and inadequate Federal Aviation Administration (FAA) oversight and direct surveillance of parachute operations. Parachute jump operators, many of which transport parachutists for revenue, maintain their aircraft under regulatory provisions that require little FAA oversight. Lack of operation-specific pilot training is also discussed. Safety recommendations to the FAA and to the United States Parachute Association are included. Appendix A details other current and past Safety Board recommendations related to parachute operations. KW - Air pilots KW - Aircraft KW - Aviation safety KW - Crash investigation KW - Emergency management KW - Inspection KW - Maintenance KW - Operations KW - Oversight KW - Parachutes KW - Performance KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/SIR0801.pdf UR - https://trid.trb.org/view/880455 ER - TY - RPRT AN - 01111508 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Union Pacific Railroad Trains, Bertram, California, November 10, 2007 PY - 2008/09/08 SP - 6p AB - On Saturday, November 10, 2007, about 12:03 p.m., eastbound Union Pacific Railroad (UP) freight train RVVCGC-07 struck the rear end of stopped eastbound UP freight train IGSMN-10 in Bertram, California. The striking train consisted of 6 locomotives and 60 loaded cars and was traveling about 28 mph when it collided with the stopped train, which consisted of 5 locomotives and 111 loaded cars. The stopped train was awaiting a scheduled meet with a westbound UP freight train when the accident occurred. As a result of the collision, the striking train’s three lead locomotives derailed; they also caught fire due to a fuel tank that ruptured on impact. The local fire department extinguished the fire. The two crewmembers on board the striking train were killed. The weather was clear, and the temperature was about 74° F. Total estimated damage was $2 million. KW - Alertness KW - Conductors (Trains) KW - Crash causes KW - Crash investigation KW - Freight trains KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Sleep KW - Wayside signals UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0804.pdf UR - https://trid.trb.org/view/870951 ER - TY - RPRT AN - 01115404 AU - National Transportation Safety Board TI - Highway Accident Brief: Rear-End Chain-Reaction Collision, State Route 121, Near Lake Butler, Florida, January 25, 2006 PY - 2008/08/22 SP - 12p AB - About 2:40 p.m. on Wednesday, January 25, 2006, a 31-year-old truck driver, operating a 75,360-pound 2004 Freightliner truck tractor and 1998 Wabash box trailer combination unit (Freightliner), departed High Springs, Florida, on an 85-mile trip to a company warehouse in Jacksonville, Florida. The driver was transporting a load of bottled water. Meanwhile, about 3:05 p.m., a 48-year-old school bus driver began her afternoon route in a 1996 Thomas Built school bus, Union County bus no. 13. The northbound school bus was stopped on State Route (SR) 121 at bus stop no. 10, near 75th SW Terrace, to discharge two students. A 1993 Pontiac Bonneville—occupied by a 15-year-old driver and six passengers, ages 20 months to 15 years—was stopped behind the school bus. As the school bus was beginning to proceed, the Freightliner collided with the rear of the Pontiac and the bus. Police estimated the speed of the Freightliner to be 62 mph. The Freightliner and the Pontiac continued forward from the impact area, departing the travel lanes to the right. The Freightliner then traveled 260 feet and collided with a 21-inch-diameter pine tree. The Pontiac was pushed 272 feet to its final position, where it was destroyed in a postcrash fire. The school bus was pushed a distance of 328 feet and came to rest on the right side of the road. Both the Freightliner and the school bus sustained extensive impact damage. All seven occupants of the Pontiac were killed. Three of the nine students on the school bus were ejected from the rear of the vehicle and landed on highway pavement, seriously injured. One other student sustained serious injuries and was extricated from the bus by firefighters. The school bus driver, who was wearing a lap shoulder belt, also sustained serious injuries. Five students and the truck driver received minor injuries. The students who had been discharged from the bus just before the accident were not injured. The National Transportation Safety Board determines that the probable cause of this accident was the failure of the truck driver to maintain alertness due to fatigue from obtaining inadequate rest. Contributing to the accident was the failure of Crete Carrier Corporation to exercise proper oversight of the driver’s hours of service. KW - Chain reactions (Traffic accidents) KW - Crash analysis KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Fatalities KW - Highway safety KW - Injuries KW - Rear end crashes KW - Traffic crashes KW - Traffic safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0805.pdf UR - https://trid.trb.org/view/873677 ER - TY - RPRT AN - 01113165 AU - National Transportation Safety Board TI - Highway Accident Brief: Motorcoach Run-Off-the-Road and Rollover Interstate 55 Near Turrell, Arkansas, October 9, 2004 PY - 2008/08/22 SP - 12p AB - On October 9, 2004, about 5:02 a.m., a 1988 Motor Coach Industries, Inc. (MCI), 47‑passenger motorcoach was southbound on Interstate 55 (I-55) near Turrell, Arkansas, transporting 29 passengers to a casino in Tunica, Mississippi. Witnesses following the motorcoach prior to the accident estimated that it had been traveling about 70 mph. At the exit 23A interchange, the motorcoach veered to the right and entered the grassy area between the exit ramp and the entrance ramp. As it rotated in a clockwise direction, the motorcoach struck an exit sign, overturning onto its left side and sliding in a southwesterly direction. The left side of the vehicle struck the westernmost side of a 2-foot-deep earthen drainage ditch, and the motorcoach continued to roll over. As it rolled, the roof opened up, allowing passengers to be thrown from the open top. The motorcoach landed 65 feet from the drainage ditch and came to rest upside down. Its roof was laying on the ground (top side up), still hinged to the right side of the vehicle. At the time of the accident, it was dark and there was no highway safety lighting. The roadway was wet from a misting rain, but there was no standing water. The National Transportation Safety Board determines that the probable cause of this accident was the motorcoach driver’s fatigued condition, which led him to drift from the left side of the roadway, contact rumble strips, oversteer to the right, and then move off the roadway. The detachment of the motorcoach roof was a contributing cause to the severity of injuries and the number of ejections. KW - Arkansas KW - Bus crashes KW - Bus drivers KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Ejection KW - Fatalities KW - Fatigue (Physiological condition) KW - Highway safety KW - Hours of labor KW - Injuries KW - Ran off road crashes KW - Rollover crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0804.pdf UR - https://trid.trb.org/view/872481 ER - TY - RPRT AN - 01111297 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Override of Elevated Exit Ramp, Interstate 75, Atlanta, Georgia, March 2, 2007 PY - 2008/07/08 SP - 76p AB - About 5:38 a.m. eastern standard time on Friday, March 2, 2007, a 2000 VanHool T2145 57-passenger motorcoach operated by Executive Coach Luxury Travel, Inc., transporting 33 members of the Bluffton University baseball team, the driver, and his wife, was traveling south on Interstate 75 in Atlanta, Georgia. According to witnesses, the motorcoach was in the southbound high occupancy vehicle (HOV) lane at milepost 250 when it departed the interstate, traveling at highway speed, onto the HOV-only left exit ramp to Northside Drive. The exit ramp came to an end at the stop sign-controlled T-intersection with Northside Drive. As the motorcoach entered the intersection at an estimated speed of 50 to 60 mph, the driver steered to the right and collided with the reinforced portland cement concrete bridge wall and chain-link security fence located along the southern edge of the eastbound lanes of the overpass. The motorcoach then overrode the bridge rail, rotated clockwise, and fell 19 feet onto the southbound lanes of the interstate. The motorcoach came to rest on its left side (driver’s side), perpendicular to the southbound lanes of Interstate 75. Two southbound passenger vehicles received minor damage from debris as the motorcoach fell onto Interstate 75; none of the passenger vehicle occupants were injured. Seven motorcoach occupants were killed: the driver, the driver’s wife, and five passengers. Seven other passengers received serious injuries, and 21 passengers received minor injuries. Major safety issues identified in this accident include inadequate HOV traffic control devices, inadequate motor carrier driver oversight, lack of event data recorders on motorcoaches, and lack of motorcoach occupant protection. As a result of its investigation, the Safety Board makes recommendations to the Federal Highway Administration and to the Georgia Department of Transportation. The Safety Board also reiterates four previous recommendations to the National Highway Traffic Safety Administration. KW - Atlanta (Georgia) KW - Bus crashes KW - Bus drivers KW - Crash causes KW - Crash investigation KW - Event data recorders KW - Fatalities KW - High occupancy vehicle lanes KW - Highway safety KW - Motor carriers KW - Occupant protection devices KW - Off ramps KW - Oversight KW - Traffic control devices UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0801.pdf UR - https://trid.trb.org/view/868754 ER - TY - RPRT AN - 01105041 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Southeastern Pennsylvania Transportation Authority Trains, Abington, Pennsylvania, July 1, 2006 PY - 2008/06/17 SP - 6p AB - On Saturday, July 1, 2006, about 2:53 p.m., southbound Southeastern Pennsylvania Transportation Authority (SEPTA) passenger train 1143 collided head on with standing northbound SEPTA train 1134 near Abington, Pennsylvania. The southbound train was traveling about 11 mph when it struck the northbound train. As a result of the collision, the control cab car and two passenger cars on the southbound train and the control cab car on the northbound train were derailed. Thirty-eight passengers were injured and treated on scene. Of those, 29 were transported to local hospitals, and 8 were admitted. All six crewmembers from both trains were also taken to local hospitals; three of them were admitted. Total property damage was about $179,700. The National Transportation Safety Board determines that the probable cause of the July 1, 2006, collision of two passenger trains near Abington, Pennsylvania, was the failure of the engineer on southbound train 1143 to comply with the wayside signals and stop the train on the main track at the Grove South Control Point. Contributing to the accident was the lack of a functioning cab signal system with automatic train control enforcement. Also contributing to the accident was a dispatcher computer alarm system that did not adequately alert the train dispatcher to the overrun signal. KW - Automatic train control KW - Crash causes KW - Crash investigation KW - Pennsylvania KW - Railroad crashes KW - Railroad safety KW - Railroad trains KW - Wayside signals UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0803.pdf UR - https://trid.trb.org/view/864660 ER - TY - RPRT AN - 01105057 AU - National Transportation Safety Board TI - Aircraft Accident Report: Runway Overrun During Landing, Pinnacle Airlines, Inc., Flight 4712, Bombardier/Canadair Regional Jet CL600-2B19, N8905F, Traverse City, Michigan, April 12, 2007 PY - 2008/06/10 SP - 212p AB - This report explains the accident involving a Bombardier/Canadair Regional Jet CL‑600-2B19, N8905F, operated by Pinnacle Airlines, Inc., which ran off the departure end of runway 28 after landing at Cherry Capital Airport, Traverse City, Michigan. The safety issues discussed in this report include the pilots’ actions and decision-making during the approach, landing, and landing roll; pilot fatigue and line check airman duty time regulations; weather and field condition information and ground operations personnel communications; and criteria for runway closures in snow and ice conditions. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air pilots KW - Air transportation crashes KW - Airport runways KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Decision making KW - Fatigue (Physiological condition) KW - Landing KW - Runway overruns KW - Snow KW - Traverse City (Michigan) KW - Weather conditions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0802.pdf UR - https://trid.trb.org/view/864661 ER - TY - RPRT AN - 01105006 AU - National Transportation Safety Board TI - Highway Accident Brief: Commuter Train Highway - Railroad Grade Crossing Accident in Elmwood Park, Illinois, November 23, 2005 PY - 2008/06/10 SP - 10p AB - About 4:41 p.m. on November 23, 2005, the day before Thanksgiving, in Elmwood Park, Illinois, a traffic queue formed within the 366-foot-wide signaled METRA highway-railroad grade crossing on eastbound West Grand Avenue. At the same time, METRA train 107 was approaching the crossing on the westbound tracks at a speed of 70 mph, as indicated by event data recorder information. The crossing lights activated and the crossing gates lowered 54 seconds before the train arrived. The traffic queue trapped some stopped vehicles within the grade crossing. As METRA train 107 approached the crossing, the engineer recognized the hazard and put the train into emergency braking. The train was unable to stop before colliding with approximately 6 of the stopped vehicles, pushing them into secondary impacts with 12 other vehicles about 4:43 p.m. Seven automobile occupants received minor-to-serious injuries, and 3 of the approximately 400 train passengers reported minor injuries. The impact destroyed 6 vehicles, and 12 vehicles had minor-to-extensive damage. The locomotive incurred minor damage and did not derail. The National Transportation Safety Board determines that the probable cause of the Elmwood Park accident was a combination of factors that led to the development of a traffic queue on the West Grand Avenue highway-rail grade crossing and prevented queued vehicles from exiting the crossing prior to the arrival of a Northeast Illinois Regional Commuter Railroad (METRA) train: the factors were the acute angle of intersection between West Grand Avenue and the railroad tracks, which resulted in an exceptionally wide grade crossing; the unusually heavy vehicle traffic that preceded the Thanksgiving holiday; and the complex street and rail pattern and related signal interactions between Harlem Avenue and the West Grand Avenue grade crossing, which frequently desynchronized the traffic signals along West Grand Avenue during peak travel times. KW - Crash causes KW - Crash investigation KW - Elmwood Park (Illinois) KW - Grade crossing protection systems KW - Highway safety KW - Injuries KW - Peak hour traffic KW - Railroad crashes KW - Railroad grade crossing collisions KW - Railroad grade crossings KW - Railroad safety KW - Traffic congestion KW - Traffic crashes KW - Traffic queuing KW - Traffic safety KW - Traffic signal control systems UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0803.pdf UR - https://trid.trb.org/view/864662 ER - TY - RPRT AN - 01120529 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data U.S. General Aviation, Calendar Year 2004 PY - 2008/05/28 SP - 56p AB - This report is a statistical compilation and review of general aviation accidents that occurred in 2004 involving U.S.-registered aircraft. As a summary of all U.S. general aviation accidents for 2004, the review is designed to inform general aviation pilots and their passengers and to provide detailed information to support future government, industry, and private research efforts and safety improvement initiatives. KW - Air transportation crashes KW - Annual reviews KW - Aviation safety KW - Crash data KW - General aviation KW - General aviation aircraft KW - Statistics KW - United States UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARG08-01.pdf UR - https://trid.trb.org/view/878808 ER - TY - RPRT AN - 01105629 AU - National Transportation Safety Board TI - Railroad Accident Report: Derailment of Norfolk Southern Railway Company Train 68QB119 with Release of Hazardous Materials and Fire New Brighton, Pennsylvania, October 20, 2006 PY - 2008/05/13 SP - 56p AB - About 10:41 p.m. eastern daylight time on Friday, October 20, 2006, Norfolk Southern Railway Company train 68QB119, en route from the Chicago, Illinois, area to Sewaren, New Jersey, derailed while crossing the Beaver River railroad bridge in New Brighton, Pennsylvania. The train consisted of a three-unit locomotive pulling 3 empty freight cars followed by 83 tank cars loaded with denatured ethanol, a flammable liquid. Twenty-three of the tank cars derailed near the east end of the bridge, with several of the cars falling into the Beaver River. Of the 23 derailed tank cars, about 20 released ethanol, which subsequently ignited and burned for about 48 hours. Some of the unburned ethanol liquid was released into the river and the surrounding soil. Homes and businesses within a seven-block area of New Brighton and in an area adjacent to the accident were evacuated for 2 days. No injuries or fatalities resulted from the accident. The Norfolk Southern Railway Company estimated total damages to be $5.8 million. The safety issues identified in this accident are ultrasonic rail inspection and rail defect management, oversight of the internal rail inspection process and requirements for internal rail inspection, and the placement of hazardous materials cars in trains for crew protection. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Federal Railroad Administration, the Pipeline and Hazardous Materials Safety Administration, and the Norfolk Southern Railway Company. KW - Crash causes KW - Crash investigation KW - Derailments KW - Fires KW - Freight trains KW - Hazardous materials KW - Inspection KW - Oversight KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0802.pdf UR - https://trid.trb.org/view/865039 ER - TY - RPRT AN - 01104015 AU - National Transportation Safety Board TI - Aircraft Accident Report: Runway Overrun During Landing, Shuttle America, Inc., Doing Business as Delta Connection Flight 6448, Embraer ERJ-170, N862RW, Cleveland, Ohio, February 18, 2007 PY - 2008/04/15 SP - 188p AB - This report explains the accident involving an Embraer ERJ-170, N862RW, operated by Shuttle America, Inc., which was landing on runway 28 at Cleveland-Hopkins International Airport, Cleveland, Ohio, during snow conditions when it overran the end of the runway, contacted an instrument landing system antenna, and struck an airport perimeter fence. The safety issues discussed in this report focus on (1) flight training for rejected landings in deteriorating weather conditions and maximum performance landings on contaminated runways, (2) standard operating procedures for the go-around callout, and (3) pilot fatigue policies. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air pilots KW - Air transportation crashes KW - Aviation safety KW - Fatigue (Physiological condition) KW - Flight training KW - Landing KW - Recommendations KW - Runway overruns KW - Snow KW - Standard operating procedures UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-reports/AAR08-01.pdf UR - https://trid.trb.org/view/863912 ER - TY - RPRT AN - 01100382 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Massachusetts Bay Transportation Authority Train 322 and Track Maintenance Equipment Near Woburn, Massachusetts, January 9, 2007 PY - 2008/03/18 SP - 34p AB - On Tuesday, January 9, 2007, at 1:38 p.m., southbound Massachusetts Bay Transportation Authority passenger train 322 operated by Massachusetts Bay Commuter Railroad struck a track maintenance vehicle that was on the track near Woburn, Massachusetts. The track maintenance vehicle was thrown forward about 210 feet; the train did not derail. Of the six maintenance-of-way employees working on or near the track maintenance vehicle, two were killed, and two were seriously injured. Emergency responders treated and released 10 passengers at the accident scene. As a result of its investigation of the accident, the National Transportation Safety Board identified the following safety issues: train dispatcher procedures for blocking track segments to protect maintenance-of- way work crews working on the track; maintenance-of-way work crews shunting signaled track to protect themselves while working on the track; and alcohol and drug use by maintenance-of-way employees in the railroad industry. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Federal Railroad Administration and the Brotherhood of Maintenance of Way Employees Division. KW - Alcohol use KW - Commuter trains KW - Crash causes KW - Crash investigation KW - Drug use KW - Employees KW - Fatalities KW - Injuries KW - Maintenance equipment KW - Maintenance of way KW - Protection KW - Railroad crashes KW - Railroad safety KW - Railroad tracks KW - Woburn (Massachusetts) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0801.pdf UR - https://trid.trb.org/view/859531 ER - TY - RPRT AN - 01091663 AU - National Transportation Safety Board TI - Highway Accident Brief: Rear-End Chain Reaction Collision, Interstate 30 West, Near Sulphur Springs, Texas, June 13, 2004 PY - 2008/02/05 SP - 13p AB - On June 13, 2004, about 8:39 p.m., a 1991 Kenworth tractor-auto transporter, traveling west on Interstate 30 (I-30), near Sulphur Springs, Texas, collided with a 2002 Hyundai Santa Fe sport utility vehicle (SUV) that was stopped in a 0.5-mile-long traffic queue in the right-hand lane at milepost 132.3. The force of the collision pushed the Hyundai forward, into and under the trailer of a 2000 Peterbilt tractor-semitrailer combination unit (see figure 2), which was in turn pushed forward into a 2003 Lincoln Navigator SUV. The Lincoln was subsequently pushed forward into the trailer of a 2000 Volvo tractor-semitrailer combination unit. A fire erupted, involving the Hyundai and the Peterbilt trailer. All four occupants of the Hyundai and the driver of the Kenworth truck were fatally injured. The two occupants of the Lincoln received minor injuries, and the occupants of the Peterbilt and Volvo trucks were not injured. At the time of the accident, the temperature was 80º Fahrenheit, the sky was clear with a visibility of 10 miles, 1 and winds were southeast at 5.8 mph. The traffic queue had formed on I-30 west due to a single-vehicle crossover accident with multiple fatalities (see figure 1), which had occurred 1.5 hours earlier, at 7:09 p.m. This accident prompted the Texas Department of Public Safety (DPS) to close all eastbound and westbound lanes of I-30 and detour traffic to parallel service roads. Tire marks from the 8:39 p.m. accident scene indicated that the Kenworth driver began braking approximately 190 feet before colliding with the Hyundai. Taking into account the tire marks and accident sequence, investigators estimated that the speed of the Kenworth truck was 62–70 mph prior to braking. Its speed at the time of collision was estimated at 50–60 mph, 2 indicating that the driver began braking approximately 2 seconds before colliding with the Hyundai. The posted speed in this area was 70 mph during daylight and 65 mph at night. An assessment of sight distance on I-30 west indicated that the driver had at least 3,000 feet of unobstructed view, or over 29 seconds at a speed of 70 mph, before reaching the traffic queue. The National Transportation Safety Board determines that the probable cause of the Sulphur Springs multivehicle accident was the failure of the driver of the 1991 Kenworth tractor‑auto transporter to identify and react in time to stopped traffic due to acute fatigue. Contributing to this accident were the failure of Waggoners Trucking Company, owner of the Kenworth truck, to provide adequate oversight of the driver’s fitness for duty and compliance with hours-of-service requirements, and the failure of the Texas Department of Public Safety and the Texas Department of Transportation to provide clear advance warning to alert approaching traffic of the incident area and traffic queue. KW - Chain reactions (Traffic accidents) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Drivers KW - Fatalities KW - Fatigue (Physiological condition) KW - Fire KW - Highway safety KW - Hours of labor KW - Injuries KW - Multiple vehicle crashes KW - Reaction time KW - Rear end crashes KW - Sport utility vehicles KW - Tractor trailer combinations KW - Traffic crashes KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Pages/HAB0802.aspx UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0802.pdf UR - https://trid.trb.org/view/851538 ER - TY - RPRT AN - 01099605 AU - National Transportation Safety Board TI - Marine Accident Report: Heeling Accident on M/V Crown Princess, Atlantic Ocean Off Port Canaveral, Florida, July 18, 2006 PY - 2008/01/30 SP - 104p AB - This report discusses the July 18, 2006, accident on the cruise ship Crown Princess in which the vessel heeled at a maximum angle of about 24°, resulting in injuries to 298 passengers and crewmembers. The vessel’s second officer, the senior watch officer on the bridge, had disengaged the automatic steering mode of the vessel’s integrated navigation system and taken manual control of the steering in an effort to counteract a perceived high rate of turn to port. He turned the wheel first to port and then between port and starboard several times, causing the vessel to suddenly heel and people to be thrown about or struck by unsecured objects. The Crown Princess incurred no structural damage, although unsecured interior items were damaged. The Safety Board’s investigation of the accident identified the following safety issues: actions of the captain, staff captain, and second officer; training in the use of integrated navigation systems; reporting of heeling incidents and accidents; and emergency response following severe incidents. On the basis of its findings, the Safety Board made recommendations to the U.S. Coast Guard, to the Cruise Lines International Association, and to SAM Electronics and Sperry Marine (manufacturers of integrated navigation systems). KW - Automatic steering control KW - Crash causes KW - Crash investigation KW - Cruise ships KW - Emergency response KW - Heeling KW - Injuries KW - Manual control KW - Navigation systems KW - Reporting KW - Training KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0801.pdf UR - https://trid.trb.org/view/855902 ER - TY - RPRT AN - 01140625 AU - National Transportation Safety Board TI - National Transportation Safety Board Annual Report to Congress, 2008 PY - 2008 SP - 178p AB - The National Transportation Safety Board (NTSB) is an independent agency charged with determining the probable cause of transportation accidents and promoting transportation safety. The NTSB investigates accidents, conducts safety studies, evaluates the effectiveness of other government agencies programs for preventing transportation accidents, and reviews the appeals of enforcement actions involving aviation and mariner certificates issued by the Federal Aviation Administration (FAA) and the U.S. Coast Guard, as well as the appeals of civil penalty actions taken by the FAA. To help prevent accidents, the NTSB develops safety recommendations based on its investigations and studies. These are issued to Federal, State, and local government agencies and to industry and other organizations in a position to improve transportation safety. Recommendations are the focal point of the NTSBs efforts to improve the safety of the nation’s transportation system. KW - Air transportation KW - Crash investigation KW - Highway transportation KW - Prevention KW - Railroad transportation KW - Reporting (Disclosure) KW - Transportation safety KW - U.S. National Transportation Safety Board KW - United States Congress UR - https://trid.trb.org/view/901014 ER - TY - RPRT AN - 01120425 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted November 2008 PY - 2008 SP - 20p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of November 2008. KW - Air transportation KW - Crash investigation KW - Crash prevention KW - Crashes KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Transportation safety UR - https://trid.trb.org/view/879179 ER - TY - RPRT AN - 01113333 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted August 2008 PY - 2008 SP - 24p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of August 2008. KW - Air transportation KW - Crash data KW - Crash investigation KW - Highway transportation KW - Railroad transportation KW - Transportation planning KW - Transportation safety UR - https://trid.trb.org/view/872663 ER - TY - RPRT AN - 01100376 AU - National Transportation Safety Board TI - Railroad Accident Brief: Washington Metropolitan Area Transit Authority Train Strikes Wayside Workers Near Eisenhower Avenue Station, Alexandria, Virginia, November 30, 2006 PY - 2008 SP - 9p AB - About 9:30 a.m. on Thursday, November 30, 2006, a northbound Washington Metropolitan Area Transit Authority (WMATA) Metrorail Yellow Line subway train struck and fatally injured two Metrorail employees who were performing a routine walking inspection along an outdoor section of main track near the Eisenhower Avenue station in Alexandria, Virginia. The accident occurred as the northbound train was traveling along track normally used for southbound traffic. The National Transportation Safety Board determines that the probable cause of the Eisenhower Avenue accident was the failure of the walking track inspectors to maintain an effective lookout for trains and the failure of the train operator to slow or stop the train until she could be certain that the workers ahead were aware of its approach and had moved to a safe area. Contributing to the accident were Washington Metropolitan Area Transit Authority Metrorail right-of-way rules and procedures that did not provide adequate safeguards to protect wayside personnel from approaching trains, that did not ensure that train operators were aware of the wayside work being performed, and that did not adequately provide for reduced train speeds through work areas. Also contributing to the accident was the lack of an aggressive program of rule compliance testing and enforcement on the Metrorail system. KW - Alexandria (Virginia) KW - Crash causes KW - Crash investigation KW - Fatalities KW - Inspection KW - Inspectors KW - Rail transit KW - Rail transit stations KW - Transit crashes KW - Transit safety KW - Washington Metropolitan Area Transit Authority UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0802.pdf UR - https://trid.trb.org/view/859535 ER - TY - RPRT AN - 01088779 AU - National Transportation Safety Board TI - Highway Accident Brief: Frontal and Sideswipe Collision Between a School Bus and a Trash Truck on Columbia Pike, Arlington, Virginia, April 18, 2005 PY - 2008 SP - 18p AB - Shortly before 8:40 a.m., on Monday, April 18, 2005, a 52-passenger school bus was traveling westbound on Columbia Pike (State Route 244) in Arlington County, Virginia, transporting 15 elementary school children, grades pre-K through 5, to the nearby Hoffman-Boston Elementary School. On approaching the signaled intersection with Courthouse Road, the school bus driver began moving the bus into the left turn lane (from which it would turn south onto Courthouse Road) and slowed it nearly to a stop. As the driver turned the vehicle, its left front encroached slightly into the left lane of the eastbound side of Columbia Pike. The driver later stated that distractions inside the bus might have affected her driving at this time. She said her attention was drawn to a student standing on a seat and to a clipboard that fell to the floor at her driving station. About 8:40 a.m., a 2003 Mack trash truck was traveling with the flow of traffic in the left eastbound lane on Columbia Pike, at a speed one witness who was traveling on the road in the same direction estimated to be approximately 30 mph. The truck reached the intersection with Courthouse Road, continued through it on a green signal and, according to several witnesses, deviated slightly leftward from its lane toward the yellow centerline. The truck collided with the school bus; the impact involved the front-left corners of both vehicles and a sideswipe. During the collision, the school bus was pushed backward, but it remained in the left turn lane following the accident. The trash truck continued eastbound about 200 feet, crossed the right eastbound lane, jumped the right curb of Columbia Pike, and came to rest. One student died at the scene and one student died 3 days later in the hospital. The truck driver, school bus driver, and one student on the bus sustained serious injuries; four students sustained minor injuries; and the remaining eight students were uninjured. The bus driver, who had been wearing her seat belt, was ejected through the broken windshield when the shoulder portion of the belt was sheared in half. Emergency responders needed approximately 1 hour to extricate the trash truck driver from the truck cab because of his legs being trapped in the wreckage. The students who suffered the most severe injuries were seated behind the driver on the left side, near the front, of the bus. The National Transportation Safety Board determines that the probable cause of this accident was the school bus driver’s encroachment into the trash truck’s lane and the trash truck driver’s failure to maintain proper lane position, for undetermined reasons, causing the front-left sides of the two vehicles to collide and the vehicles to sideswipe each other. KW - Arlington County (Virginia) KW - Automatic steering control KW - Crash causes KW - Crash investigation KW - Distraction KW - Fatalities KW - Frontal crashes KW - Highway safety KW - Injuries KW - Lane position KW - Left turn lanes KW - Left turns KW - Refuse collection vehicles KW - School bus drivers KW - School bus passengers KW - School buses KW - School children KW - Side crashes KW - Traffic crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0801.pdf UR - https://trid.trb.org/view/849572 ER - TY - RPRT AN - 01084828 AU - National Transportation Safety Board TI - Collision of Runaway CN Railway Locomotives and Northern Illinois Regional Commuter Railroad (Metra) Train in Chicago, Illinois, on March 7, 2007 PY - 2007/12/20 SP - 4p AB - About 9:30 p.m. on Wednesday, March 7, 2007, the crew of CN Railway (CN) train R95491 left two locomotives, which had only air brakes applied, on a grade at the CN’s interchange point at Lumber Street in Chicago, Illinois. The two uncontrolled and unmanned locomotives rolled to the north. They traveled from CN’s track No. 4 onto Amtrak’s track No. 4, where, at 9:56 p.m., they collided with the lead locomotive of standing Northern Illinois Regional Commuter Railroad (Metra) train 839. At the time of the collision, the event recorder data indicated, the speed of the runaway CN locomotives was 14 mph. They had traveled about 1,789 feet. About 55 passengers were aboard the eighth Metra passenger car at the time of the collision. The other seven passenger cars were empty. Seven passengers and the Metra engineer and assistant conductor were transported to area hospitals with minor injuries; they were treated and released. The total property damage was estimated to be $75,766. The National Transportation Safety Board determines the probable cause of the collision was the failure of the CN Railway engineer and conductor to secure the CN Railway locomotives before leaving them unattended. KW - Air brakes KW - Chicago (Illinois) KW - Conductors (Trains) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Event data recorders KW - Injuries KW - Locomotives KW - Railroad crashes KW - Railroad engineers KW - Railroad safety KW - Speed UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0704.pdf UR - https://trid.trb.org/view/844474 ER - TY - RPRT AN - 01105611 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. Air Carrier Operations Calendar Year 2004 PY - 2007/12/19 SP - 70p AB - This report covers aircraft operated by U.S. air carriers under Title 14 Parts 121 and 135, of the Code of Federal Regulations (CFR). Air carriers are generally defined as operators that fly aircraft in revenue service. Data for the years 1995–2003 are included to provide an historical context for the 2004 statistics. Much of the information in this review is presented in graphs and tables. Readers who prefer to view or manipulate tabular data may access the data set online at http://www.ntsb. gov/aviation/stats.htm. KW - Air transportation crashes KW - Aircraft operations KW - Airlines KW - Aviation safety KW - Crash data KW - United States UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARC08-01.pdf UR - https://trid.trb.org/view/865035 ER - TY - RPRT AN - 01095899 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-43 PY - 2007/12/17 SP - 5p AB - This safety recommendation, addressed to Mr. Alan Bishop, Chief Operating Officer, Equity Transportation Company, Inc., addresses improvements to the company's safety program. It is derived from the National Transportation Safety Board's (NTSB's) investigation of a multiple-vehicle accident that occurred on July 16, 2004, near Chelsea, Michigan. The NTSB makes the following recommendation to Equity Transportation Company, Inc.: (H-07-43) Implement a driver log review program that accounts for, tracks, and audits all modifications to paper logs and that also collects and retains all available electronic supporting documentation to verify driver compliance with Federal commercial driver hours-of-service regulations. KW - Auditing KW - Compliance KW - Equity Transportation Company, Incorporated KW - Fatigue (Physiological condition) KW - Hours of labor KW - Motor carriers KW - Multiple vehicle crashes KW - Oversight KW - Recommendations KW - Surveys KW - Truck crashes KW - Truck drivers UR - https://trid.trb.org/view/855891 ER - TY - RPRT AN - 01095898 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-41 and -42 PY - 2007/12/17 SP - 8p AB - These safety recommendations, addressed to the Honorable John H. Hill, Administrator, Federal Motor Carrier Safety Administration, address motor carrier oversight of drivers and accountability for record-of-duty driver logs. The recommendations are derived from the National Transportation Safety Board's (NTSB's) investigation of the July 16, 2004, multiple-vehicle accident near Chelsea, Michigan. The NTSB makes the following recommendations to the Federal Motor Carrier Safety Administration: (H-07-41) Require all interstate commercial vehicle carriers to use electronic on-board recorders that collect and maintain data concerning driver hours of service in a valid, accurate, and secure manner under all circumstances, including accident conditions, to enable the carriers and their regulators to monitor and assess hours-of-service compliance; and (H-07-42) As an interim measure and until industrywide use of electronic on-board recorders is mandated, as recommended in Safety Recommendation H-07-41, prevent log tampering and submission of false paper logs by requiring motor carriers to create and maintain audit control systems that include, at a minimum, the retention of all original and corrected paper logs and the use of bound and sequentially numbered logs. KW - Accountability KW - Auditing KW - Commercial vehicle operations KW - Compliance KW - Data recorders KW - Driver monitoring KW - Electronic on board recorders KW - Fatigue (Physiological condition) KW - Hours of labor KW - Multiple vehicle crashes KW - Oversight KW - Recommendations KW - Surveys KW - Truck crashes KW - Truck drivers KW - U.S. Federal Motor Carrier Safety Administration UR - https://trid.trb.org/view/855890 ER - TY - RPRT AN - 01088776 AU - National Transportation Safety Board TI - Aircraft Accident Report: Inflight Cargo Fire, United Parcel Service Company Flight 1307, McDonnell Douglas DC-8-71F, N748UP, Philadelphia, Pennsylvania, February 7, 2006 PY - 2007/12/04 SP - 112p AB - This report explains the accident involving a McDonnell Douglas DC-8-71F, N748UP, operated by United Parcel Service Company, which landed at its destination airport, Philadelphia International Airport, Philadelphia, Pennsylvania, after a cargo smoke indication in the cockpit. The safety issues discussed in this report include inadequacies in the following areas: guidance and checklists relating to in-flight fire and smoke, smoke and fire detection system test certification requirements, fire suppression system requirements, aircraft rescue and firefighting training, cargo airplane emergency exit requirements, hazardous materials information dissemination procedures, and transport of lithium batteries on board aircraft. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration, the Cargo Airline Association, and the Pipeline and Hazardous Materials Safety Administration. KW - Air transportation crashes KW - Aviation safety KW - Certification KW - Crash investigation KW - Emergency exits KW - Fire KW - Fire detection systems KW - Hazardous materials KW - Information dissemination KW - Lithium batteries KW - Philadelphia (Pennsylvania) KW - Smoke KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0707.pdf UR - https://trid.trb.org/view/849238 ER - TY - RPRT AN - 01083039 AU - National Transportation Safety Board TI - Highway Accident Brief: Rear-End Chain Reaction Collision, Interstate 94 East, Near Chelsea, Michigan, July 16, 2004 PY - 2007/12/04 SP - 14p AB - On Friday, July 16, 2004, about 12:00 p.m., a 1999 Sterling tractor towing a 1997 Great Dane semitrailer was part of a traffic queue moving slowly east on Interstate 94 (I‑94), behind a 2004 Saturn station wagon approaching the Fletcher Road overpass. The queue had formed following an earlier accident in the eastbound lanes of a highway maintenance zone. At the same time, a 2000 Kenworth tractor towing a 2000 Hyundai semitrailer, owned by Equity Transportation Company, Inc. (Equity), was traveling behind the queue on I-94, approaching the Fletcher Road overpass at a witness-estimated speed of 60 mph. The Kenworth driver failed to slow in time for the traffic queue ahead. A 115-foot preimpact skid mark indicated that the Kenworth driver applied the brakes and swerved to the right almost immediately before his truck collided with the Sterling’s semitrailer. The left front of his truck struck the right rear of the Sterling’s semitrailer, compressing the cab of the Kenworth about 6 feet to the rear, trapping and fatally injuring its driver. The impact propelled the Sterling tractor-semitrailer into the Saturn in front of it, resulting in minor injuries to the Sterling driver and to a passenger in the Saturn. The weather was clear and the roadway was dry. The Kenworth driver’s sight distance was more than 1 mile. The accident occurred within a 25-mile-long maintenance zone that involved 21 bridge renovation projects. The National Transportation Safety Board determines that the probable cause of the July 16, 2004, multiple-vehicle accident near Chelsea, Michigan, was the accident driver’s failure to stop upon encountering traffic congestion in a temporary traffic control zone likely due to a reduced state of alertness associated with failure to obtain adequate rest. Contributing to the accident were Equity Transportation Company, Inc.’s, insufficient regard for, and oversight of, driver compliance with Federal commercial motor vehicle hours-of-service regulations , which endangered the safety of its drivers and the traveling public; the Federal Motor Carrier Safety Administration’s failure to require motor carriers to use tamperproof driver’s logs; and the Michigan Department of Transportation’s failure to conduct a merge traffic capacity analysis as part of a bridge rehabilitation project. KW - Alertness KW - Bridges KW - Chain reactions (Traffic accidents) KW - Chelsea (Michigan) KW - Compliance KW - Crash causes KW - Crash investigation KW - Fatalities KW - Highway capacity KW - Highway safety KW - Hours of labor KW - Injuries KW - Interstate highways KW - Merging traffic KW - Oversight KW - Rear end crashes KW - Regulations KW - Rehabilitation (Maintenance) KW - Rest periods KW - Saturn automobile KW - Speed KW - Surveys KW - Tractor trailer combinations KW - Traffic congestion KW - Traffic crashes KW - Traffic queuing KW - Traffic safety KW - Truck crashes KW - Truck drivers KW - Trucking safety KW - Work zones UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0701.pdf UR - https://trid.trb.org/view/842261 ER - TY - RPRT AN - 01083032 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Crash into Potomac River, LifeNet, Inc., Eurocopter EC-135 P2, N136LN, Oxon Hill, Maryland, January 10, 2005 PY - 2007/12/04 SP - 16p AB - On January 10, 2005, about 2311 eastern standard time, a Eurocopter Deutschland GmbH EC-135 P2 helicopter, N136LN, operated by LifeNet, Inc., as Life Evac 2, crashed into the Potomac River during low-altitude cruise flight near Oxon Hill, Maryland. The certificated commercial pilot and the flight paramedic were killed, and the flight nurse received serious injuries. The helicopter was destroyed. The positioning flight was conducted under the provisions of 14 Code of Federal Regulations (CFR) Part 91 and visual flight rules (VFR) with a company flight plan filed. Night visual meteorological conditions prevailed at the time of the accident. The National Transportation Safety Board determines that the probable cause of this accident was the pilot’s failure to identify and arrest the helicopter’s descent, which resulted in controlled flight into terrain. Contributing to the accident were the dark night conditions, limited outside visual references, and the lack of an operable radar altimeter in the helicopter. KW - Air ambulances KW - Air transportation crashes KW - Altimeters KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Descent KW - Fatalities KW - Helicopter pilots KW - Helicopters KW - Low altitude KW - Night KW - Oxon Hill (Maryland) KW - Potomac River KW - Radar KW - Visual flight UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0704.pdf UR - https://trid.trb.org/view/842260 ER - TY - RPRT AN - 01081218 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Crash of Sundance Helicopters, Inc., Aerospatiale AS350BA, N270SH, Near Grand Canyon West Airport, Arizona, September 20, 2003 PY - 2007/10/30 SP - 26p AB - On September 20, 2003, about 1238 mountain standard time, an Aerospatiale AS350BA helicopter, N270SH, operated by Sundance Helicopters, Inc., crashed into a canyon wall while maneuvering through Descent Canyon, about 1.5 nautical miles (nm) east of Grand Canyon West Airport (1G4) in Arizona. The pilot and all six passengers on board were killed, and the helicopter was destroyed by impact forces and postcrash fire. The air tour sightseeing flight was operated under the provisions of 14 Code of Federal Regulations (CFR) Part 135. Visual meteorological conditions (VMC) prevailed for the flight, which was operated under visual flight rules on a company flight plan. The helicopter was transporting passengers from a helipad at 1G4 (helipad elevation 4,775 feet mean sea level [msl]) near the upper rim of the Grand Canyon to a helipad designated “the Beach” (elevation 1,300 msl) located next to the Colorado River at the floor of the Grand Canyon. The National Transportation Safety Board determines that the probable cause of this accident was the pilot’s disregard of safe flying procedures and misjudgment of the helicopter’s proximity to terrain, which resulted in an in-flight collision with a canyon wall. Contributing to the accident was the failure of Sundance Helicopters and the Federal Aviation Administration to provide adequate surveillance of Sundance’s air tour operations in Descent Canyon. KW - Air tours KW - Air transportation crashes KW - Arizona KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Descent Canyon KW - Earth walls KW - Fatalities KW - Grand Canyon KW - Helicopter pilots KW - Helicopters KW - Human error KW - Judgment (Human characteristics) KW - Oversight KW - Proximity KW - Sundance Helicopters KW - U.S. Federal Aviation Administration KW - Visual flight UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0703.pdf UR - https://trid.trb.org/view/840156 ER - TY - RPRT AN - 01082671 AU - National Transportation Safety Board TI - Marine Accident Brief: Boiler Rupture on Bahamian Cruise Ship S/S Norway, Port of Miami, Florida, May 25, 2003 PY - 2007/10/29 SP - 55p AB - At 0637 on May 25, 2003, the Bahamas-registered passenger vessel S/S Norway, with 911 crewmembers and 2,135 passengers on board, suffered a boiler rupture in the aft boiler room. The accident occurred about an hour after the vessel had moored in Miami, Florida, at the end of a 7-day Caribbean cruise. As a result of the accident, 8 crewmembers sustained fatal injuries, 10 suffered serious injuries, and 7 received minor injuries. No passengers were injured. The National Transportation Safety Board investigated the Norway accident under the authority of the Independent Safety Board Act of 1974 and according to Safety Board rules. The designated parties to the investigation were the U.S. Coast Guard; NCL; Bureau Veritas (BV), the classification society that inspected the Norway; Bahamas Maritime Authority, the vessel’s flag state; Siemens, the manufacturer of the vessel’s boiler control and monitoring system; and Lloyd Werft Shipyard, which performed or contracted out boiler repairs in Bremerhaven, Germany, in 1987 and 1990. The National Transportation Safety Board determines that the probable cause of the boiler rupture on the Norway was the deficient boiler operation, maintenance, and inspection practices of Norwegian Cruise Line, which allowed material deterioration and fatigue cracking to weaken the boiler. Inadequate boiler surveys by Bureau Veritas contributed to the cause of the accident. KW - Boilers KW - Condition surveys KW - Cracking KW - Crash causes KW - Crash investigation KW - Cruise lines KW - Cruise ships KW - Deterioration KW - Fatalities KW - Injuries KW - Inspection KW - Maintenance KW - Materials KW - Miami (Florida) KW - Operations KW - Rupture KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0703.pdf UR - https://trid.trb.org/view/841470 ER - TY - RPRT AN - 01082679 AU - National Transportation Safety Board TI - Railroad Accident Brief: Rear-end Collision of Norfolk Southern Trains near Lincoln, Alabama, January 18, 2006 PY - 2007/10/26 SP - 10p AB - About 4:17 p.m., central standard time,1 on January 18, 2006, eastbound Norfolk Southern Railway (NS) freight train No. 226A117 (226), while traveling about 50 mph near Lincoln, Alabama, diverted from the main track onto a siding track where it struck the rear of eastbound NS train No. 22RA116 (22R), which was stopped in the siding. The collision derailed the three locomotives and the first seven cars of train 226 and the rear three cars of train 22R. The three crewmembers of train 226 were injured. Property damage was estimated to be about $5.2 million. The National Transportation Safety Board determines that the probable cause of the January 18, 2006, collision of Norfolk Southern Railway train 226 with the rear of Norfolk Southern Railway train 22R at Lincoln, Alabama, was the failure by the crew of train 226 to recognize an extra lighted aspect (caused by reflected sunlight) as an imperfectly displayed signal and to treat it as a most restrictive indication. Contributing to the accident was Norfolk Southern Railway’s inadequate illustrations and text in the rulebook and inadequate training to prepare crews to recognize a signal displaying an extra lighted aspect as an imperfectly displayed signal. Also contributing to the accident was the lack of a positive train control system that would have intervened when the crew did not respond appropriately to the signal. KW - Crash causes KW - Crash investigation KW - Derailments KW - Freight trains KW - Injuries KW - Lincoln (Alabama) KW - Norfolk Southern Railway Company KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Railroad signals KW - Rear end crashes KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0703.pdf UR - https://trid.trb.org/view/841864 ER - TY - RPRT AN - 01083125 AU - National Transportation Safety Board TI - Railroad Accident Report: Derailment of Washington Metropolitan Area Transit Authority Train near the Mt. Vernon Square Station Washington, D.C. January 7, 2007 PY - 2007/10/16 SP - 42p AB - On January 7, 2007, about 3:45 p.m. eastern standard time, northbound Washington Metropolitan Area Transit Authority Metrorail train 504 derailed one car as the train traversed a crossover from track 2 to track 1. The accident occurred in an underground tunnel on the Metrorail Green Line near the Mt. Vernon Square 7th Street-Convention Center station at chain marker E2 23+28. The train was traveling about 18 mph as it approached the station. The train consisted of six cars. The fifth car from the head end of the train derailed. About 80 passengers were on board at the time of the accident. Twenty-three passengers were transported to local hospitals for treatment and released. Emergency response personnel from Washington, D.C., provided the on-scene treatment and transportation of the injured passengers. The safety issues identified in this accident are wheel-truing procedures, mitigating measures for wheel climb derailments, and Washington Metropolitan Area Transit Authority interdepartmental coordination. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Washington Metropolitan Area Transit Authority. KW - Coordination KW - Countermeasures KW - Crash investigation KW - Derailments KW - Emergency medical services KW - Injuries KW - Interagency relations KW - Rail transit KW - Railroad crashes KW - Subways KW - Transit crashes KW - Washington (District of Columbia) KW - Washington Metropolitan Area KW - Washington Metropolitan Area Transit Authority KW - Wheel truing UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0703.pdf UR - https://trid.trb.org/view/842330 ER - TY - RPRT AN - 01095897 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-40 PY - 2007/10/03 SP - 15p AB - The National Transportation Safety Board (NTSB) is concerned about motorcycle safety and the growing number of riders that have been killed or injured in motorcycle crashes. To better understand the reasons behind these increasing numbers, the NTSB held a public forum in September 2006. The forum focused on a number of areas in which motorcycle safety improvements are promising, including motorcycle helmet usage. This safety recommendation is derived from NTSB's findings related to motorcycle helmet effectiveness and universal helmet laws. The NTSB makes the following recommendation to the 8 States, the District of Columbia, and the 4 Territories with universal motorcycle helmet laws/regulations not specifically requiring Federal Motor Vehicle Safety Standard 218-compliant helmets: (H-07-40) Amend current laws to specify that all persons shall wear a Department of Transportation Federal Motor Vehicle Safety Standard 218-compliant motorcycle helmet while riding (operating), or as a passenger on any motorcycle. KW - Crash injuries KW - Fatalities KW - Motorcycle crashes KW - Motorcycle helmets KW - Motorcycle safety KW - Recommendations KW - State laws UR - https://trid.trb.org/view/855889 ER - TY - RPRT AN - 01095896 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-39 PY - 2007/10/03 SP - 15p AB - The National Transportation Safety Board (NTSB) is concerned about motorcycle safety and the growing number of riders that have been killed or injured in motorcycle crashes. To better understand the reasons behind these increasing numbers, the NTSB held a public forum in September 2006. The forum focused on a number of areas in which motorcycle safety improvements are promising, including motorcycle helmet usage. This safety recommendation is derived from NTSB's findings related to motorcycle helmet effectiveness and universal helmet laws. The NTSB makes the following recommendation to the 27 States and 1 Territory with partial motorcycle helmet laws: (H-07-39) Amend current laws to require that all persons shall wear a Department of Transportation Federal Motor Vehicle Safety Standard 218-compliant motorcycle helmet while riding (operating), or as a passenger on any motorcycle. KW - Crash injuries KW - Fatalities KW - Motorcycle crashes KW - Motorcycle helmets KW - Motorcycle safety KW - Recommendations KW - State laws UR - https://trid.trb.org/view/855875 ER - TY - RPRT AN - 01095895 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-38 PY - 2007/10/03 SP - 13p AB - The National Transportation Safety Board (NTSB) is concerned about motorcycle safety and the growing number of riders that have been killed or injured in motorcycle crashes. To better understand the reasons behind these increasing numbers, the NTSB held a public forum in September 2006. The forum focused on a number of areas in which motorcycle safety improvements are promising, including motorcycle helmet usage. This safety recommendation is derived from NTSB's findings related to motorcycle helmet effectiveness and universal helmet laws. The NTSB makes the following recommendation to the three States with no motorcycle helmet laws (Illinois, Iowa, and New Hampshire): (H-07-38) Require that all persons shall wear a Department of Transportation Federal Motor Vehicle Safety Standard 218-compliant motorcycle helmet while riding (operating), or as a passenger on any motorcycle. KW - Crash injuries KW - Fatalities KW - Motorcycle crashes KW - Motorcycle helmets KW - Motorcycle safety KW - Recommendations KW - State laws UR - https://trid.trb.org/view/855874 ER - TY - RPRT AN - 01095894 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-37 PY - 2007/10/03 SP - 12p AB - The National Transportation Safety Board (NTSB) is concerned about motorcycle safety and the growing number of riders who have been killed or injured in motorcycle crashes. To better understand the reasons behind these numbers, the NTSB held a public forum in September 2006. One of the most comprehensive documents concerning motorcycle safety to appear in the last decade is the National Agenda for Motorcycle Safety (NAMS), which was referenced several times during the forum. The NTSB is encouraged by the attention that the NAMS has generated and by federal, state, and community-level efforts to respond to its recommendations. However, the NTSB believes that safety will be improved by prioritizing the NAMS recommendations using objective criteria, continuously tracking the effectiveness of new and ongoing efforts, and promoting efforts that are judged to be most successful at improving safety. Therefore, the NTSB makes the following recommendation to all States: (H-07-37) Provide information to the National Highway Traffic Safety Administration (NHTSA) on the effectiveness of your motorcycle safety efforts to assist NHTSA with its effort to reprioritize the NAMS recommendations. KW - Data collection KW - Motorcycle safety KW - Motorcycles KW - National Agenda for Motorcycle Safety KW - Recommendations KW - Safety KW - States KW - Strategic planning KW - U.S. National Highway Traffic Safety Administration UR - https://trid.trb.org/view/855860 ER - TY - RPRT AN - 01095893 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-35 and -36 PY - 2007/10/03 SP - 7p AB - The National Transportation Safety Board (NTSB) is concerned about motorcycle safety and the growing number of riders who have been killed or injured in motorcycle crashes. To better understand the reasons behind these numbers, the NTSB held a public forum in September 2006. One of the most comprehensive documents concerning motorcycle safety to appear in the last decade is the National Agenda for Motorcycle Safety (NAMS), which was referenced several times during the forum. The NTSB recognizes that the NAMS is an important document in motorcycle safety, and that safety will be improved by prioritizing the NAMS recommendations using objective criteria, continuously tracking the effectiveness of new and ongoing efforts, and promoting efforts that are judged to be most successful at improving safety. Therefore, the NTSB makes the following recommendations to NHTSA: (H-07-35) Reprioritize the NAMS recommendations based on objective criteria, including known safety outcomes; and (H-07-36) Following completion of the reprioritization of the NAMS requested in Safety Recommendation H-07-35, implement an action plan for states and others, such as federal agencies, manufacturers, insurance organizations, and advocacy groups, to carry out those recommendations that are determined to be of high priority. KW - Action plans KW - Motorcycle safety KW - Motorcycles KW - National Agenda for Motorcycle Safety KW - Recommendations KW - Safety KW - Strategic planning KW - U.S. National Highway Traffic Safety Administration UR - https://trid.trb.org/view/855859 ER - TY - RPRT AN - 01095892 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-34 PY - 2007/10/03 SP - 8p AB - The National Transportation Safety Board (NTSB) is concerned about motorcycle safety and the growing number of riders that have been killed or injured in motorcycle crashes. To better understand the reasons behind these numbers, the NTSB held a public forum in September 2006. One of the issues raised at the public forum was the need for accurate data reflecting motorcycle activity trends, such as motorcycle registration and vehicle miles traveled (VMT). In an effort to address concerns with the motorcycle registration and VMT data and to identify best methods to obtain these data, the Federal Highway Administration (FHWA) and the National Highway Traffic Safety Administration (NHTSA) are cohosting a Motorcycle Travel Symposium on October 10-12, 2007. The NTSB is concerned that the momentum generated by the symposium may not continue, and that it is critical that these data be accurate and reliable. Therefore, the NTSB makes the following recommendation to the FHWA: (H-07-34) Following the 2007 Motorcycle Travel Symposium, develop guidelines for the states to use to gather accurate motorcycle registrations and motorcycle VMT data. The guidelines should include information on the various methods to collect registrations and VMT data and how these methods can be put into practice. KW - Data accuracy KW - Data collection KW - Guidelines KW - Motor vehicle licensing KW - Motorcycle crashes KW - Motorcycle safety KW - Recommendations KW - U.S. Federal Highway Administration KW - U.S. National Highway Traffic Safety Administration KW - Vehicle miles of travel UR - https://trid.trb.org/view/855858 ER - TY - RPRT AN - 01080582 AU - National Transportation Safety Board TI - Aircraft Accident Report: Runway Overrun and Collision, Southwest Airlines Flight 1248, Boeing 737-7H4, N471WN Chicago Midway International Airport, Chicago, Illinois, December 8, 2005 PY - 2007/10/02 AB - This report explains the accident involving a Boeing 737-7H4, N471WN, operated by Southwest Airlines (SWA), which departed the end of runway 31C after landing at Chicago Midway International Airport. The safety issues discussed in this report include the flight crew’s decisions and actions, the clarity of assumptions used in on board performance computers, SWA policies, guidance, and training, arrival landing distance assessments and safety margins, runway surface condition assessments and braking action reports, airplane-based friction measurements, and runway safety areas. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Airport runways KW - Aviation safety KW - Braking KW - Chicago (Illinois) KW - Chicago Midway International Airport KW - Crash investigation KW - Decision making KW - Distance KW - Flight crews KW - Friction KW - Landing KW - Measurement KW - Onboard computers KW - Pavement conditions KW - Performance KW - Policy KW - Southwest Airlines KW - Surface course (Pavements) KW - Training UR - http://app.ntsb.gov/doclib/reports/2007/AAR0706.pdf UR - https://trid.trb.org/view/839630 ER - TY - RPRT AN - 01115414 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Bahamas-Registered Tankship M/V Kition with Interstate Highway 10 Bridge Pier, Baton Rouge, Louisiana, February 10, 2007 PY - 2007/08/12 SP - 44p AB - This report discusses the February 10, 2007, accident in which the nearly 800-foot-long tankship M/V Kition struck a pier on the Interstate Highway 10 bridge over the Mississippi River at Baton Rouge while the Louisiana state pilot was attempting to turn the vessel immediately above the bridge. The vessel’s bow knocked a 2- to 3-foot section of concrete out of the bridge pier, causing an estimated $8 million in damage to the bridge and $726,500 in damage to the ship. No injuries or pollution resulted from the accident. The Safety Board’s investigation identified the following safety issues: pilot’s actions, pilotage oversight, and postaccident alcohol testing. On the basis of its findings, the Safety Board made recommendations to the U.S. Coast Guard and to the Board of New Orleans–Baton Rouge Steamship Pilot Examiners for the Mississippi River. KW - Allisions KW - Baton Rouge (Louisiana) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Ship pilotage KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0803.pdf UR - https://trid.trb.org/view/873904 ER - TY - RPRT AN - 01076657 AU - National Transportation Safety Board TI - Aircraft Accident Report: Attempted Takeoff From Wrong Runway, Comair Flight 5191, Bombardier CL-600-2B19, N431CA, Lexington, Kentucky, August 27, 2006 PY - 2007/07/26 SP - 174p AB - This report explains the accident involving a Bombardier CL-600-2B19, N431CA, operated by Comair, Inc., which crashed during takeoff from Blue Grass Airport, Lexington, Kentucky. The safety issues discussed in this report focus on the need for (1) improved flight deck procedures, (2) the implementation of cockpit moving map displays or cockpit runway alerting systems, (3) improved airport surface marking standards, and (4) air traffic control policy changes in the areas of taxi and takeoff clearances and task prioritization. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air traffic control KW - Air transportation crashes KW - Airport runways KW - Alert systems KW - Aviation safety KW - Blue Grass Airport KW - Cockpits KW - Crash investigation KW - Data displays KW - Flight decks KW - Lexington (Kentucky) KW - Maps KW - Policy KW - Road markings KW - Surface course (Pavements) KW - Takeoff KW - Taxiing UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0705.pdf UR - https://trid.trb.org/view/836014 ER - TY - RPRT AN - 01076631 AU - National Transportation Safety Board TI - Highway Accident Report: Ceiling Collapse in the Interstate 90 Connector Tunnel, Boston, Massachusetts, July 10, 2006 PY - 2007/07/10 SP - 132p AB - About 11:01 p.m. eastern daylight time on Monday, July 10, 2006, a 1991 Buick passenger car occupied by a 46-year-old driver and his 38-year-old wife was traveling eastbound in the Interstate 90 connector tunnel in Boston, Massachusetts, en route to Logan International Airport. As the car approached the end of the Interstate 90 connector tunnel, a section of the tunnel’s suspended concrete ceiling became detached from the tunnel roof and fell onto the vehicle. Concrete panels from the ceiling crushed the right side of the vehicle roof as the car came to rest against the north wall of the tunnel. A total of about 26 tons of concrete and associated suspension hardware fell onto the vehicle and the roadway. The driver’s wife, occupying the right-front seat, was fatally injured; the driver was able to escape with minor injuries. Major safety issues identified in this accident include insufficient understanding among designers and builders of the nature of adhesive anchoring systems; lack of standards for the testing of adhesive anchors in sustained tensile-load applications; inadequate regulatory requirements for tunnel inspections; and lack of national standards for the design of tunnel finishes. As a result of its investigation of this accident, the National Transportation Safety Board makes safety recommendations to the Federal Highway Administration; the American Association of State Highway and Transportation Officials; the departments of transportation of the 50 States and the District of Columbia; the International Code Council; ICC Evaluation Service, Inc.; Powers Fasteners, Inc.; Sika Corporation; the American Concrete Institute; the American Society of Civil Engineers; and the Associated General Contractors of America. KW - Adhesives KW - Anchorages KW - Automobiles KW - Boston (Massachusetts) KW - Ceilings KW - Collapse KW - Concrete KW - Crash investigation KW - Design KW - Fatalities KW - Highway safety KW - Inspection KW - Interstate 90 KW - Regulation KW - Standards KW - Tensile loads KW - Testing KW - Traffic crashes KW - Traffic safety KW - Tunnels KW - Vehicle roofs UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0702.pdf UR - https://trid.trb.org/view/836017 ER - TY - RPRT AN - 01095878 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-12 through -14 PY - 2007/06/27 SP - 3p AB - These safety recommendations, addressed to Mr. Peter Pantuso, President and CEO, American Bus Association, and Mr. Victor Parra, President and CEO, United Motorcoach Association, address the dissemination of information on wheel bearing maintenance and the serious consequences of lack of lubrication and subsequent wheel bearing failure. The recommendations are derived from an investigation of the September 23, 2005, fire on a motorcoach on Interstate 45 near Wilmer, Texas, in which 23 passengers were fatally injured, 2 were seriously injured, and 19 received minor injuries. The National Transportation Safety Board makes the following safety recommendations to the American Bus Association and the United Motorcoach Association: (H-07-12) Disseminate to your motorcoach and bus operator members an advisory bulletin emphasizing the importance of proper wheel bearing maintenance, particularly the importance of checking the oil level in oil-lubricated bearings (also known as oil bath bearings) and inspecting the undercarriage of the tag axle wheels to detect wheel seal leaks, and the serious consequences of lack of lubrication and subsequent wheel bearing failure; (H-07-13) Advise your motorcoach manufacturer members to review product maintenance manuals and, if the manuals do not emphasize the importance of wheel bearing lubrication, to revise them to specifically warn that daily inspection of hub oil levels and wheel seals is vital to prevent wheel bearing failure and that bypassing this requirement is a dangerous practice that can lead to a wheel fire or other serious consequences; and (H-07-14) Advise your motorcoach manufacturer members to disseminate, for those vehicles already sold and in service, a customer advisory bulletin on the importance of proper wheel bearing maintenance, specifying the type of equipment or oil bath bearings that require an undercarriage inspection to detect wheel seal leaks and alerting customers to the serious consequences of lack of lubrication and subsequent wheel bearing failure. KW - American Bus Association KW - Information dissemination KW - Inspection KW - Leakage KW - Lubrication KW - Manuals KW - Recommendations KW - Seals (Devices) KW - United Motorcoach Association KW - Vehicle fires KW - Vehicle maintenance KW - Wheels UR - https://trid.trb.org/view/855804 ER - TY - RPRT AN - 01095877 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-11 PY - 2007/06/27 SP - 4p AB - This safety recommendation, addressed to six motorcoach manufacturers, addresses the use of materials and designs for fuel system components that are known to provide fire protection. The recommendation is derived from an investigation of the September 23, 2005, fire on a motorcoach on Interstate 45 near Wilmer, Texas, in which 23 passengers were fatally injured, 2 were seriously injured, and 19 received minor injuries. The National Transportation Safety Board makes the following recommendation: (H-07-11) Until the National Highway Traffic Safety Administration has developed a performance standard for enhanced fire protection of fuel systems in newly manufactured motorcoaches and included it in the "Federal Motor Vehicle Safety Standards," as requested in Safety Recommendation H-07-4, use materials and designs for fuel system components that are known to provide fire protection for the system. KW - Buses KW - Fire resistant materials KW - Fuel systems KW - Industries KW - Motor carriers KW - Recommendations KW - Vehicle design KW - Vehicle fires UR - https://trid.trb.org/view/855790 ER - TY - RPRT AN - 01095876 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-9 through -11 PY - 2007/06/27 SP - 4p AB - These safety recommendations, addressed to Mr. Robert L. Capstick, Director of Engineering, Motor Coach Industries, Inc., address the dissemination of information on wheel bearing lubrication and the use of materials and designs for fuel system components that are known to provide fire protection. The recommendations are derived from an investigation of the September 23, 2005, fire on a motorcoach on Interstate 45 near Wilmer, Texas, in which 23 passengers were fatally injured, 2 were seriously injured, and 19 received minor injuries. The National Transportation Safety Board makes the following safety recommendations to Motor Coach Industries, Inc.: (H-07-9) Revise your product maintenance manuals to emphasize the importance of wheel bearing lubrication, specifically warning that daily inspection of hub oil levels and wheel seals is vital to prevent wheel bearing failure and that bypassing this requirement is a dangerous practice that can lead to a wheel well fire or other serious consequences; (H-07-10) For those vehicles already sold and in service, disseminate a customer advisory bulletin on the importance of proper wheel bearing maintenance, specifying the type of equipment or oil bath bearings that require an undercarriage inspection to detect wheel seal leaks and alerting customers to the serious consequences of lack of lubrication and subsequent wheel bearing failure; and (H-07-11) Until the National Highway Traffic Safety Administration has developed a performance standard for enhanced fire protection of fuel systems in newly manufactured motorcoaches and included it in the Federal Motor Vehicle Safety Standards, use materials and designs for fuel system components that are known to provide fire protection for the system. KW - Buses KW - Fire prevention KW - Fire resistant materials KW - Fuel systems KW - Leakage KW - Lubrication KW - Motor carriers KW - Motor Coach Industries, Incorporated KW - Recommendations KW - Seals (Devices) KW - Vehicle design KW - Vehicle fires KW - Vehicle maintenance KW - Wheels UR - https://trid.trb.org/view/855786 ER - TY - RPRT AN - 01095875 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-4 through -8 PY - 2007/06/27 SP - 7p AB - These safety recommendations, addressed to the Honorable Nicole R. Nason, Administrator, National Highway Traffic Safety Administration (NHTSA), concern the design of motorcoaches and buses. These recommendations are derived from an investigation of the September 23, 2005, fire on a motorcoach on Interstate 45 near Wilmer, Texas, in which 23 passengers were fatally injured, 2 were seriously injured, and 19 received minor injuries. The National Transportation Safety Board makes the following safety recommendations to NHTSA: (H-07-4) Develop a Federal Motor Vehicle Safety Standard (FMVSS) to provide enhanced fire protection of the fuel system in areas of motorcoaches and buses where the system may be exposed to the effects of a fire; (H-07-5) Develop a FMVSS to provide fire-hardening of exterior fire-prone materials, such as those in areas around wheel wells, to limit the potential for flame spread into a motorcoach or bus passenger compartment; (H-07-6) Develop detection systems to monitor the temperature of wheel well compartments in motorcoaches and buses to provide early warning of malfunctions that could lead to fires; (H-07-7) Evaluate the need for a FMVSS that would require installation of fire detection and suppression systems on motorcoaches; and (H-07-8) Evaluate current emergency evacuation designs of motorcoaches and buses by conducting simulation studies and evacuation drills that take into account, at a minimum, acceptable egress times for various postaccident environments, including fire and smoke; unavailable exit situations; and the current above-ground height and design of window exits to be used in emergencies by all potential vehicle occupants. KW - Buses KW - Emergency exits KW - Evacuation KW - Federal Motor Vehicle Safety Standards KW - Fire detection systems KW - Fire resistance KW - Fire resistant materials KW - Fire suppression systems KW - Fuel systems KW - Motor carriers KW - Recommendations KW - U.S. National Highway Traffic Safety Administration KW - Vehicle design KW - Vehicle fires KW - Wheels UR - https://trid.trb.org/view/855785 ER - TY - RPRT AN - 01095874 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-07-1 through -3 PY - 2007/06/27 SP - 8p AB - These safety recommendations, addressed to the Honorable John H. Hill, Administrator, Federal Motor Carrier Safety Administration, address deficiencies in the current compliance review system of the Federal Motor Carrier Safety Administration (FMCSA) which does not effectively identify unsafe motor carriers and prevent them from operating. These recommendations are derived from an investigation of the September 23, 2005, fire on a motorcoach on Interstate 45 near Wilmer, Texas, in which 23 passengers were fatally injured, 2 were seriously injured, and 19 received minor injuries. The National Transportation Safety Board makes the following safety recommendations to the FMCSA: (H-07-1) Establish a process to continuously gather and evaluate information on the causes, frequency, and severity of bus and motorcoach fires and conduct ongoing analysis of fire data to measure the effectiveness of the fire prevention and mitigation techniques identified and instituted as a result of the Volpe National Transportation Systems Center fire safety analysis study; (H-07-2) Revise the "Federal Motor Carrier Safety Regulations" at 49 CFR 393.205 to prohibit a commercial vehicle from operating with wheel seal or other hub lubrication leaks; and (H-07-3) To protect the traveling public until completion of the Comprehensive Safety Analysis 2010 Initiative, immediately issue an Interim Rule to include all "Federal Motor Carrier Safety Regulations" in the current compliance review process so that all violations of regulations are reflected in the calculation of a carrier's final rating. KW - Buses KW - Compliance KW - Consumer protection KW - Federal Motor Carrier Safety Regulations KW - Fire prevention KW - Leakage KW - Lubrication KW - Motor carriers KW - Recommendations KW - U.S. Federal Motor Carrier Safety Administration KW - Vehicle fires KW - Wheels UR - https://trid.trb.org/view/855784 ER - TY - RPRT AN - 01076646 AU - National Transportation Safety Board TI - Marine Accident Report: Fire Aboard Construction Barge Athena 106, West Cote Blanche Bay, Louisiana, October 12, 2006 PY - 2007/06/14 SP - 82p AB - This report discusses the accident in which a 5-ton spud (mooring shaft) unintentionally released from the uninspected construction barge Athena 106 and struck a natural gas pipeline buried in West Cote Blanche Bay, Louisiana. The Athena 106 and another barge were both being pushed by the towing vessel Miss Megan. The gas ignited and created a fireball that engulfed the Miss Megan and both barges. Five people were killed and two survived; one barge worker was officially listed as missing as of the report date. Damages were estimated at $150,000 for the Athena 106 and $650,000 for the Miss Megan. The estimated value of the released natural gas was $6,800; replacing the ruptured pipeline cost an estimated $800,000. The National Transportation Safety Board identified the following safety issues during its accident investigation: the failure to use safety devices, and the limited oversight of vessels not subject to inspection. On the basis of its findings, the Safety Board made recommendations to the Occupational Safety and Health Administration, the U.S. Coast Guard, Athena Construction (Athena 106 owner/operator), and Central Boat Rentals (Miss Megan owner/operator). KW - Barges KW - Crash investigation KW - Fatalities KW - Fires KW - Inspection KW - Marine safety KW - Mooring KW - Natural gas pipelines KW - Oversight KW - Safety equipment KW - Ships KW - Water transportation crashes KW - West Cote Blanche Bay (Louisiana) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0701.pdf UR - https://trid.trb.org/view/836015 ER - TY - RPRT AN - 01055133 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Anhydrous Ammonia Pipeline Rupture Near Kingman, Kansas, October 27, 2004 PY - 2007/06/14 SP - 15p AB - About 11:15 a.m. central daylight time on October 27, 2004, an 8-inch-diameter pipeline owned by Magellan Midstream Partners, L.P., and operated by Enterprise Products Operating L.P. ruptured near Kingman, Kansas, and released approximately 4,858 barrels (204,000 gallons) of anhydrous ammonia. Nobody was killed or injured due to the release. The anhydrous ammonia leaked into a creek and killed more than 25,000 fish including some from threatened species. The cost of the accident was $680,715, including $459,415 for environmental remediation. The National Transportation Safety Board determines that the probable cause of the pipeline rupture was a pipe gouge created by heavy equipment damage to the pipeline during construction in 1973 or subsequent excavation activity at an unknown time that initiated metal fatigue cracking and led to the eventual rupture of the pipeline. Contributing to the severity of the accident was the pipeline controller’s failure to accurately evaluate available operating data and initiate a timely shutdown of the pipeline. As a result of its investigation of the October 27, 2004, anhydrous ammonia pipeline accident, the National Transportation Safety Board makes the following safety recommendations: (A) To the Pipeline and Hazardous Materials Safety Administration: Require in 49 Code of Federal Regulations 195.52 that a pipeline operator must have a procedure to calculate and provide a reasonable initial estimate of released product in the telephonic report to the National Response Center (P-07-7); Require in 49 Code of Federal Regulations 195.52 that a pipeline operator must provide an additional telephonic report to the National Response Center if significant new information becomes available during the emergency response (P-07-8); Require an operator to revise its pipeline risk assessment plan whenever it has failed to consider one or more risk factors that can affect pipeline integrity (P-07-9); and (B) To Enterprise Products Operating L.P.: Provide initial and recurrent training for all controllers that includes simulator or noncomputerized simulations of abnormal operating conditions that indicate pipeline leaks (P-07-10). KW - Anhydrous ammonia KW - Construction damage KW - Cracking KW - Crash causes KW - Fatigue (Mechanics) KW - Leak detection KW - Leakage KW - Pipeline accidents KW - Pipeline controllers KW - Pipeline operators KW - Pipelines KW - Recommendations KW - Rupture KW - United States Code. Title 49 UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB0702.pdf UR - https://trid.trb.org/view/814811 ER - TY - RPRT AN - 01079265 AU - National Transportation Safety Board TI - Aircraft Accident Report: In-flight Separation of Right Wing, Flying Boat, Inc. (doing business as Chalk's Ocean Airways) Flight 101, Grumman Turbo Mallard (G-73T), N2969, Port of Miami, Florida, December 19, 2005 PY - 2007/05/30 SP - 74p AB - This report explains the accident involving Flying Boat, Inc. (doing business as Chalk’s Ocean Airways) Flight 101, a Grumman Turbo Mallard (G-73T) amphibious airplane, which crashed into a shipping channel adjacent to the Port of Miami, Florida, shortly after takeoff from the Miami Seaplane Base. Safety issues discussed in this report focus on air carrier maintenance programs and practices and Federal Aviation Administration (FAA) oversight procedures for air carrier maintenance programs. Safety recommendations concerning these issues are addressed to the FAA. KW - Air transportation crashes KW - Airlines KW - Aviation safety KW - Maintenance KW - Oversight KW - Port of Miami KW - Seaplanes KW - Takeoff KW - U.S. Federal Aviation Administration KW - Wings (Aircraft) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0704.pdf UR - https://trid.trb.org/view/836641 ER - TY - RPRT AN - 01076654 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding of the Hong Kong-Registered Containership New Delhi Express in the New York Harbor, Kill Van Kull Waterway Near Buoy 14, April 15, 2006 PY - 2007/05/30 SP - 19p AB - At 0420 on Saturday, April 15, 2006, the Hong Kong–registered container ship New Delhi Express, with a master, 2 pilots, 21 crewmembers, and 3 noncrewmember guests (relatives of crewmembers) on board, ran aground in the Kill Van Kull waterway in New York Harbor. The New Delhi Express and two of the three tugs assisting it were damaged in the accident. No one was injured, and no water pollution resulted from the accident. The National Transportation Safety Board determines that the probable cause of the grounding of the New Delhi Express was the error of the docking pilot in not using all available resources to determine the vessel’s position as he navigated the Kill Van Kull waterway. Contributing to the cause of the grounding was the failure of both pilots to practice good bridge resource management. As a result of its investigation of the grounding of the New Delhi Express, the National Transportation Safety Board made the following safety recommendations: (1) To the U.S. Coast Guard - Use the circumstances of this accident related to the improper redeployment of buoy 14 in the Kill Van Kull waterway as a “lesson learned” and disseminate the information to appropriate personnel, emphasizing the need to verify all buoy positioning data during routine position checks and during buoy redeployments (M-07-2). (2) To the State Commissions Whose Harbor Pilots Work With Docking Pilots - Require your harbor and docking pilots to take part in recurrent joint training exercises that emphasize the concepts and procedures of bridge resource management (M-07-3). KW - Bridges KW - Buoys KW - Containerships KW - Crash causes KW - Crash investigation KW - Docking KW - Groundings (Maritime crashes) KW - Lessons learned KW - Marine safety KW - New York Harbor KW - Position fixing KW - Position indicators KW - Recommendations KW - Resource management KW - Ship pilotage KW - Ship pilots KW - Training KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0702.pdf UR - https://trid.trb.org/view/836012 ER - TY - RPRT AN - 01080602 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Crash During Turn Maneuver, Cirrus SR-20, N929CD Manhattan, New York City, October 11, 2006 PY - 2007/05/01 SP - 16p AB - On October 11, 2006, about 1442 eastern daylight time, a Cirrus Design SR20, N929CD, operated as a personal flight, crashed into an apartment building in Manhattan, New York City, while attempting to maneuver above the East River. The two pilots on board the airplane, a certificated private pilot who was the owner of the airplane and a passenger who was a certificated commercial pilot with a flight instructor certificate, were killed. One person on the ground sustained serious injuries, two people on the ground sustained minor injuries, and the airplane was destroyed by impact forces and postcrash fire. The flight was operating under the provisions of 14 Code of Federal Regulations (CFR) Part 91, and no flight plan was filed. Marginal visual flight rules (MVFR) conditions prevailed at the time of the accident. The National Transportation Safety Board determines that the probable cause of this accident was the pilots’ inadequate planning, judgment, and airmanship in the performance of a 180º turn maneuver inside of a limited turning space. KW - Air pilots KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Injuries KW - Judgment (Human characteristics) KW - Manhattan (New York, New York) KW - New York (New York) KW - Planning KW - Turning (Aircraft pilotage) KW - Visual flight UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0702.pdf UR - https://trid.trb.org/view/839633 ER - TY - RPRT AN - 01076642 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Two CN Freight Trains, Anding, Mississippi, July 10, 2005 PY - 2007/03/20 SP - 66p AB - Abstract: On Sunday, July 10, 2005, about 4:15 a.m., central daylight time, two CN freight trains collided head on in Anding, Mississippi. The collision occurred on the CN Yazoo Subdivision, where the trains were being operated under a centralized traffic control signal system on single track. Signal data indicated that the northbound train, IC 1013 North, continued past a stop (red) signal at North Anding and collided with the southbound train, IC 1023 South, about 1/4 mile beyond the signal. The collision resulted in the derailment of 6 locomotives and 17 cars. About 15,000 gallons of diesel fuel were released from the locomotives and resulted in a fire that burned for about 15 hours. Two crewmembers were on each train; all four were killed. As a precaution, about 100 Anding residents were evacuated; they did not report any injuries. Property damages exceeded $9.5 million; clearing and environmental cleanup costs totaled about $616,800. The safety issues discussed in this report are the lack of a positive train control system that would stop trains when authorized limits are exceeded, the absence of a requirement for alerters on the leading locomotive of freight trains, the lack of accurate and timely train consist information for emergency responders, the lack of procedures ensuring railroads, States, and communities conduct joint emergency response planning for hazardous material releases, and the need for locomotive cab voice recorders. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Federal Railroad Administration, the Pipeline and Hazardous Materials Safety Administration, the Occupational Safety and Health Administration, the CN, and all Class I railroads. KW - Anding (Mississippi) KW - Cabs (Vehicle compartments) KW - Crash investigation KW - Derailments KW - Diesel fuels KW - Disaster preparedness KW - Emergency management KW - Emergency responders KW - Evacuation KW - Fatalities KW - Fires KW - Freight trains KW - Frontal crashes KW - Hazardous materials KW - Locomotives KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Train consist KW - Voice recorders UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0701.pdf UR - https://trid.trb.org/view/836022 ER - TY - RPRT AN - 01054743 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Fire on Interstate 45 During Hurricane Rita Evacuation Near Wilmer, Texas, September 23, 2005 PY - 2007/02/21 SP - 142p AB - On September 23, 2005, a 1998 Motor Coach Industries, Inc. (MCI), 54-passenger motorcoach, operated by Global Limo Inc., of Pharr, Texas, was traveling northbound on Interstate 45 (I-45) near Wilmer, Texas. The motorcoach, en route from Bellaire to Dallas, Texas, as part of the evacuation in anticipation of Hurricane Rita, was carrying 44 assisted living facility residents and nursing staff. The trip had begun about 3:00 p.m. on September 22. Fifteen hours later, about 6:00 a.m. on the following day, a motorist noticed that the right-rear tire hub was glowing red and alerted the motorcoach driver, who stopped in the left traffic lane and then proceeded to the right shoulder of I-45 near milepost 269.5. The driver and nursing staff exited the motorcoach and observed flames emanating from the right-rear wheel well. As they initiated an evacuation of the motorcoach, with assistance from passersby, heavy smoke and fire quickly engulfed the entire vehicle. Twenty-three passengers were fatally injured. Of the 21 passengers who escaped, 2 were seriously injured and 19 received minor injuries; the motorcoach driver also received minor injuries. Major safety issues identified in this investigation include vehicle fire reporting and inconsistent data within Federal accident databases, the ineffective compliance review program of the Federal Motor Carrier Safety Administration (FMCSA), emergency egress from motorcoaches, fire resistance of motorcoach materials and designs, manufacturer maintenance information on wheel bearing components, transportation of partially pressurized aluminum cylinders, and emergency transportation of persons with special needs. As a result of this accident investigation, the Safety Board makes recommendations to the FMCSA, the National Highway Traffic Safety Administration, the Pipeline and Hazardous Materials Safety Administration, the Fraternal Order of Police, the International Association of Chiefs of Police, the International Association of Fire Chiefs, the International Association of Fire Fighters, the National Association of State EMS Officials, the National Sheriffs’ Association, the National Volunteer Fire Council, MCI and other motorcoach manufacturers, the United Motorcoach Association, and the American Bus Association. The Safety Board reiterates two recommendations to the U.S. Department of Transportation. KW - Aged KW - Aluminum KW - Bearings KW - Bus crashes KW - Bus transportation KW - Crash investigation KW - Crash reports KW - Cylinders (Geometry) KW - Design KW - Disasters and emergency operations KW - Emergency exits KW - Emergency transportation KW - Evacuation KW - Fatalities KW - Fire causes KW - Fire resistance KW - Fire resistant materials KW - Flames KW - Highway safety KW - Highway travel KW - Hurricane Rita, 2005 KW - Injuries KW - Interstate highways KW - Maintenance KW - Passengers KW - Pressurization KW - Smoke KW - Special purpose buses KW - Traffic safety KW - Vehicle fires KW - Wheels KW - Wilmer (Texas) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0701.pdf UR - https://trid.trb.org/view/813772 ER - TY - RPRT AN - 01079319 AU - National Transportation Safety Board TI - Aircraft Accident Report: Weather Encounter and Subsequent Collision into Terrain, Bali Hai Helicopter Tours, Inc., Bell 206B, N16849, Kalaheo, Hawaii, September 24, 2004 PY - 2007/02/13 SP - 66p AB - This report explains the accident involving a Bell 206B helicopter, N16849, registered to and operated by Bali Hai Helicopter Tours, Inc., of Hanapepe, Hawaii, which impacted mountainous terrain in Kalaheo, Hawaii, on the island of Kauai, 8.4 miles northeast of Port Allen Airport, in Hanapepe. The safety issues discussed in this report include the influence of pilot experience and operator scheduling on in-flight decision-making; the lack of Federal Aviation Administration (FAA) oversight of 14 Code of Federal Regulations Part 91 air tour operators; the need for national air tour safety standards; and the lack of direct FAA surveillance of commercial air tour operators in Hawaii. KW - Air tours KW - Air transportation crashes KW - Aviation safety KW - Decision making KW - Hawaii KW - Helicopter pilots KW - Helicopters KW - Operators (Persons) KW - Oversight KW - Pilot experience KW - Safety standards KW - Scheduling KW - Surveillance KW - U.S. Federal Aviation Administration KW - Weather conditions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0703.pdf UR - https://trid.trb.org/view/836643 ER - TY - RPRT AN - 01079321 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash During Approach to Landing, Circuit City Stores, Inc., Cessna Citation 560, N500AT, Pueblo, Colorado, February 16, 2005 PY - 2007/01/23 SP - 86p AB - This report explains the accident involving a Cessna Citation 560, N500AT, operated by Martinair, Inc., for Circuit City Stores, Inc., which crashed about 4 nautical miles east of Pueblo Memorial Airport, Pueblo, Colorado, while on an instrument landing system approach to runway 26R. The safety issues discussed in this report include inadequate training on operations in icing conditions, inadequate deice boot system operational guidance, the need for automatic deice boot systems, inadequate certification requirements for flight into icing conditions, and inadequate stall warning margins in icing conditions. KW - Air transportation crashes KW - Aviation safety KW - Certification KW - Cessna aircraft KW - Deicing KW - Icing KW - Instrument landing systems KW - Pueblo (Colorado) KW - Stall KW - Training KW - Warning devices UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0702.pdf UR - https://trid.trb.org/view/836645 ER - TY - RPRT AN - 01080557 AU - National Transportation Safety Board TI - Aircraft Accident Report: Crash of Pinnacle Airlines Flight 3701, Bombardier CL-600-2B19, N8396A, Jefferson City, Missouri, October 14, 2004 PY - 2007/01/09 SP - 173p AB - This report explains the accident involving a Bombardier CL-600-2B19, N8396A, which crashed into a residential area about 2.5 miles south of Jefferson City Memorial Airport, Jefferson City, Missouri. During the flight, both engines flamed out after a pilot-induced aerodynamic stall and were unable to be restarted. Safety issues discussed in this report focus on flight crew training in the areas of high altitude climbs, stall recognition and recovery, and double engine failures; flight crew professionalism; and the quality of some parameters recorded by flight data recorders on regional jet airplanes. KW - Air transportation crashes KW - Altitude KW - Aviation safety KW - Climbing flight KW - Crash causes KW - Crash investigation KW - Data quality KW - Data recorders KW - Failure KW - Flames KW - Flight crews KW - Jefferson City (Missouri) KW - Jet engines KW - Professionalism KW - Stall KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0701.pdf UR - https://trid.trb.org/view/839647 ER - TY - RPRT AN - 01386585 AU - National Transportation Safety Board AU - National Transportation Safety Board TI - Lessons learned and lives saved: 1967-2007 PY - 2007 IS - SR-07/01 SP - 41p AB - To help mark the National Transportation Safety Board's (NTSB) 40th anniversary, this report highlights some of the thousands of transportation safety improvements that have resulted from NTSB accident investigations and recommendations. Accidents have been prevented, lives saved and injuries reduced because of NTSB inspired safety advances in all modes of transportation: aviation, highway, marine, railroad and pipeline. This report also gives a brief history of the Safety Board, its responsibilities, and the legislation that created it, that strengthened its independence, and that has expanded its safety role over the years. This report includes information on the "Most Wanted List." The list focuses on additional safety advances the Safety Board strongly believes are needed to further increase transportation safety. KW - Accident investigation KW - Air transport KW - Air transportation KW - Crash investigation KW - Highway safety KW - History KW - History KW - Policy KW - Policy KW - Rail transport KW - Railroad transportation KW - Research KW - Research needs KW - Road safety KW - Road safety (engineering and vehicles) KW - Road safety (human factors) KW - Sea transport KW - Usa KW - Water transportation UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR0701.pdf UR - https://trid.trb.org/view/1154347 ER - TY - RPRT AN - 01111157 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendations Adopted December 2007 PY - 2007 SP - 34p AB - This publication contains safety recommendations in air, rail, and highway modes of transportation adopted by the Transportation Safety Board during the month of December 2007. KW - Accident proneness KW - Air transportation KW - Crash investigation KW - Highway traffic KW - Highway transportation KW - Railroad transportation KW - Recommendations KW - Traffic crashes KW - Transportation safety UR - https://trid.trb.org/view/870321 ER - TY - RPRT AN - 01100396 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. Air Carrier Operations, Calendar Year 2003 PY - 2007 SP - 72p AB - The National Transportation Safety Board’s Review of 2003 Aircraft Accident Data: U.S. Air Carrier Operations covers aircraft operated by U.S. air carriers under Title 14, Parts 121 and 135, of the Code of Federal Regulations. Air carriers are generally defined as operators that fly aircraft in revenue service. To provide an historical context for this 2003 review, data for the years 1994–2003 are also presented. Much of the information in this review is presented in graphs and tables. Readers who prefer to view or manipulate tabular data may access the data set online at http://www.ntsb.gov/aviation/stats.htm. A list of 2003 air carrier accidents is presented in appendix A. KW - Air transportation crashes KW - Aircraft operations KW - Airlines KW - Aviation safety KW - Crash data KW - Statistics KW - United States UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARC07-01.pdf UR - https://trid.trb.org/view/859503 ER - TY - RPRT AN - 01054042 AU - National Transportation Safety Board TI - National Transportation Safety Board. We Are All Safer: Lessons Learned and Lives Saved 1967-2007. 5th Edition PY - 2007///5th Edition SP - 54p AB - To help mark the NTSB’s 40th anniversary, this report highlights some of the thousands of transportation safety improvements that have resulted from NTSB accident investigations and recommendations. Accidents have been prevented, lives saved and injuries reduced because of NTSB-inspired safety advances in all modes of transportation: aviation, highway, marine, railroad and pipeline. This reports also gives a brief history of the Safety Board, its responsibilities, and the legislation that created it, that strengthened its independence, and that has expanded its safety role over the years. This report includes information on the “Most Wanted List.” The list focuses on additional safety advances the Safety Board strongly believes are needed to further increase transportation safety. The report also lists noteworthy Safety Board public forums and meetings, and a list of Board Members, 1967 through the present. KW - Aviation safety KW - Countermeasures KW - Crash investigation KW - Crashes KW - Fatalities KW - Highway safety KW - History KW - Injuries KW - Legislation KW - Lessons learned KW - Marine safety KW - Pipeline safety KW - Prevention KW - Railroad safety KW - Recommendations KW - Transportation safety KW - U.S. National Transportation Safety Board KW - United States UR - http://app.ntsb.gov/doclib/reports/2007/SR0701.pdf UR - https://trid.trb.org/view/811539 ER - TY - RPRT AN - 01095881 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-28 and H-03-09 (reiterated) PY - 2006/11/30 SP - 8p AB - This safety recommendation, addressed to the 20 States that do not have driver distraction codes on their traffic accident investigation forms, addresses cellular telephone use while driving. The recommendation is derived from the National Transportation Safety Board (NTSB) investigation of a November 14, 2004, motorcoach collision with the Alexandria Avenue bridge overpass, George Washington memorial Parkway, Alexandria, Virginia. The NTSB determined that the probable cause of this accident was the bus driver's failure to notice and respond to posted low-clearance warning signs and to the bridge itself due to cognitive distraction resulting from conversing on a hands-free cellular telephone while driving. The NTSB makes the following recommendation to all 50 States and the District of Columbia: (H-06-28) Enact legislation to prohibit cellular telephone use by commercial driver's license holders with a passenger-carrying or school bus endorsement, while driving under the authority of that endorsement, except in emergencies. The NTSB also reiterates an earlier recommendation: (H-03-09) Add driver distraction codes, including codes for interactive wireless communication device use, to your traffic accident investigation forms. KW - Bus drivers KW - Buses KW - Cellular telephones KW - Commercial drivers KW - Crash causes KW - Crash investigation KW - Distraction KW - Forms (Documents) KW - Legislation KW - Recommendations KW - States UR - https://trid.trb.org/view/855827 ER - TY - RPRT AN - 01095880 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-29 PY - 2006/11/30 SP - 7p AB - This safety recommendation, addressed to the motorcoach industry, public bus, and school bus associations and unions, addresses cellular telephone use while driving. The recommendation is derived from the National Transportation Safety Board (NTSB) investigation of a November 14, 2004, motorcoach collision with the Alexandria Avenue bridge overpass, George Washington Memorial Parkway, Alexandria, Virginia. The NTSB determined that the probable cause of this accident was the bus driver's failure to notice and respond to posted low-clearance warning signs and to the bridge itself due to cognitive distraction resulting from conversing on a hands-free cellular telephone while driving. The NTSB makes the following recommendation to the motorcoach industry, public bus, and school bus associations and unions: (H-06-29) Develop formal policies prohibiting cellular telephone use by commercial driver's license holders with a passenger-carrying or school bus endorsement, while driving under the authority of that endorsement, except in emergencies. KW - Bus drivers KW - Buses KW - Cellular telephones KW - Commercial drivers KW - Crash causes KW - Motorcoach industry KW - Recommendations UR - https://trid.trb.org/view/855822 ER - TY - RPRT AN - 01095879 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-27 PY - 2006/11/30 SP - 4p AB - This safety recommendation, addressed to the Honorable John H. Hill, Administrator, Federal Motor Carrier Safety Administration (FMCSA), addresses cellular telephone use while driving. The recommendation is derived from the National Transportation Safety Board (NTSB) investigation of a November 14, 2004, motorcoach collision with the Alexandria Avenue bridge overpass, George Washington Memorial Parkway, Alexandria, Virginia. The NTSB determined that the probable cause of this accident was the bus driver's failure to notice and respond to posted low-clearance warning signs and to the bridge itself due to cognitive distraction resulting from conversing on a hands-free cellular telephone while driving. The NTSB makes the following recommendation to the FMCSA: (H-06-27) Publish regulations prohibiting cellular telephone use by commercial driver's license holders with a passenger-carrying or school bus endorsement, while driving under the authority of that endorsement, except in emergencies. KW - Bus drivers KW - Buses KW - Cellular telephones KW - Commercial drivers KW - Crash causes KW - Recommendations KW - U.S. Federal Motor Carrier Safety Administration UR - https://trid.trb.org/view/855817 ER - TY - RPRT AN - 01051426 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Collision With the Alexandria Avenue Bridge Overpass, George Washington Memorial Parkway, Alexandria, Virginia, November 14, 2004 PY - 2006/11/21 SP - 48p AB - On November 14, 2004, about 9:30 a.m., eastern standard time, a 44-year-old bus driver departed the Baltimore/Washington International Thurgood Marshall Airport, operating a 2000 Prevost, 58-passenger motorcoach owned by Eyre Bus Service, Inc., (Eyre) for an approximately 60-mile trip to Mount Vernon, Virginia. This vehicle was the second one of a two-bus team. About 10:40 a.m., the bus was traveling southbound in the right lane of the George Washington Memorial Parkway in Alexandria, Virginia, at an electronic control module–recorded speed of approximately 46 mph. Upon approaching the Alexandria Avenue bridge, the bus driver passed warning signs indicating that the bridge had a 10-foot, 2- inch clearance in the right lane. The driver remained in the right lane and drove the 12-foot-high bus under the bridge, colliding with the underside and side of the overpass. At the time of the accident, the 13-foot, 4-inch-high left lane was available to the bus, and the lead Eyre bus was in the left lane ahead of the accident bus. Witnesses and the bus driver himself reported that the bus driver was talking on a hands-free cellular telephone at the time of the accident. Of the 27 student passengers, 10 received minor injuries and 1 sustained serious injuries. The bus driver and chaperone were uninjured. The bus’s roof was destroyed. Major safety issues identified in this accident include low bridge clearance, cellular telephone use while driving, and collection of adequate cellular telephone accident data. As a result of this accident, the Safety Board makes recommendations to the Federal Motor Carrier Safety Administration, the 50 States and the District of Columbia, the American Bus Association, the United Motorcoach Association, the Community Transportation Association of America, the American Public Transportation Association, the National Association for Pupil Transportation, the National School Transportation Association, the National Association of State Directors of Pupil Transportation Services, the International Brotherhood of Teamsters, and the Amalgamated Transit Union. The Safety Board also reiterates Safety Recommendation H-03-09 to the 20 States that do not yet have driver distraction codes on their traffic accident investigation forms. KW - Alexandria (Virginia) KW - Bridge clearances KW - Bridges KW - Bus crashes KW - Bus drivers KW - Cellular telephones KW - Crash causes KW - Crash data KW - Data collection KW - Distraction KW - Highway safety KW - Injuries KW - Motor carriers KW - Overpasses KW - Traffic crashes KW - Traffic safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0604.pdf UR - https://trid.trb.org/view/810212 ER - TY - RPRT AN - 01037450 AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation R-06-18 PY - 2006/10/26 SP - 6p AB - These safety recommendations, addressed to Mr. Edward R. Hamburger, Association of American Railroads and Mr. Richard F. Timmons, American Short Line and Regional Railroad Association, address railroad practices related to notification of and coordination with local emergency responders in accidents involving the release of hazardous materials. The recommendations are derived from the Safety Board’s investigation of the October 15, 2005, collision of two UP freight trains at UP’s Texarkana rail yard, and are consistent with the evidence NTSB found and the analysis it performed. The recommendations are as follows: (1) To all railroads that operate railroad yards: In coordination with communities adjacent to your railroad yards, develop and implement emergency planning and response procedures for handling releases of hazardous materials. These procedures should address, at a minimum, initial notification procedures, response actions for the safe handling of releases of the various types of hazardous materials transported, identification of key contact personnel, conduct of emergency drills and exercises, and identification of the resources to be provided and the actions to be taken by the railroad and the community (R-85-53). (2) To all Class I railroads and railroad systems: Develop, implement, and keep current, in coordination with communities adjacent to your railroad yards and along your hazardous materials routes, written emergency response plans and procedures for handling release of hazardous materials. The procedures should address, at a minimum, key railroad personnel and means of contact, procedures to identify the hazardous materials being transported, identification of resources for technical assistance that may be needed during the response effort, procedures for coordination of activities between railroad and emergency response personnel, and the conduct of disaster drills or other appropriate methods to test emergency response plans (R-91-15). (3) To the American Short Line Railroad Association: Encourage the regional and local railroads in your membership that transport hazardous materials to develop, implement, and keep current, in coordination with communities adjacent to their railroad yards and along their hazardous materials routes, written emergency response plans and procedures for handling releases of hazardous materials. The procedures should address, at a minimum, key railroad personnel and means of contact, procedures to identify the hazardous materials being transported, identification of resources for technical assistance that may be needed during the response effort, procedures for coordination of activities between railroad and emergency response personnel, and the conduct of disaster drills or other appropriate methods to test emergency response plans (R-91-17). (4) To the Association of American Railroads and the American Short Line and Regional Railroad Association: Using the circumstances of the accident in Texarkana, Arkansas, on October 15, 2005, reemphasize through your publications, web site, and meetings the importance of conducting periodic joint emergency response drills and exercises with communities adjacent to railroad yards and along hazardous materials routes, to help ensure effective communications and coordination when accidents occur (R-06-18). KW - Communication KW - Communities KW - Contacts (People) KW - Coordination KW - Disaster preparedness KW - Disasters and emergency operations KW - Emergency drills KW - Emergency responders KW - Handling and storage KW - Hazardous materials KW - Hazardous materials release KW - Notification KW - Personnel KW - Procedures KW - Railroad crashes KW - Railroad safety KW - Railroad yards KW - Recommendations KW - Routes KW - Testing KW - Texarkana (Arkansas) KW - Written plan KW - Written procedures UR - http://www.ntsb.gov/safety/safety-recs/recletters/R06_18.pdf UR - https://trid.trb.org/view/793422 ER - TY - RPRT AN - 01139216 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Two Union Pacific Railroad Freight Trains, Texarkana, Arkansas, October 15, 2005 PY - 2006/10/17 SP - 14p AB - At 4:56 a.m., central daylight time, on October 15, 2005, westbound Union Pacific Railroad (UP) train ZYCLD 13 collided with the rear of standing UP train MPBHG 15 in the UP rail yard in Texarkana, Arkansas. The collision resulted in the puncture of a railroad tank car containing propylene, a compressed flammable gas. The propylene was heavier than air and flowed near the ground into a nearby neighborhood. The flowing gas reached a house where an unknown ignition source ignited the gas, and the house exploded. The single occupant was killed. The fire moved quickly along the flowing gas back to the punctured tank car. A second, unoccupied, home was destroyed in the fire, and a wooden railroad trestle burned completely. Approximately 3,000 residents within a 1-mile radius of the punctured tank car were advised to evacuate the area. The two crews and the employees working at the Texarkana yard were not injured, and they evacuated the area safely. Between 5:00 a.m. and 7:00 a.m., the wind was calm, the visibility was 10 miles, and the temperature was approximately 59° F. Total damage was $2.4 million, including $325,975 in equipment damage and $2,053,198 in track damage. The National Transportation Safety Board determines that the probable cause of the October 15, 2005, collision was the failure of the crew of train ZYCLD 13 to remain attentive and alert and thereby able to stop short of an observable standing train. Contributing to the severity of the accident was the puncture of a tank car during the collision, which resulted in the release of propylene and a fire. KW - Crash causes KW - Crash investigation KW - Disasters and emergency operations KW - Emergency management KW - Explosions KW - Hazardous materials KW - Railroad crashes KW - Railroad safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0604.pdf UR - https://trid.trb.org/view/898513 ER - TY - RPRT AN - 01139229 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Union Pacific Railroad Train MHOTU-23 With BNSF Railway Company Train MEAP-TUL-126-D With Subsequent Derailment and Hazardous Materials Release, Macdona, Texas, June 28, 2004 PY - 2006/07/06 SP - 74p AB - About 5:03 a.m., central daylight time, on Monday, June 28, 2004, a westbound Union Pacific Railroad (UP) freight train traveling on the same main line track as an eastbound BNSF Railway Company (BNSF) freight train struck the midpoint of the 123-car BNSF train as the eastbound train was leaving the main line to enter a parallel siding. The accident occurred at the west end of the rail siding at Macdona, Texas, on the UP’s San Antonio Service Unit. The collision derailed the 4 locomotive units and the first 19 cars of the UP train as well as 17 cars of the BNSF train. As a result of the derailment and pileup of railcars, the 16th car of the UP train, a pressure tank car loaded with liquefied chlorine, was punctured. Chlorine escaping from the punctured car immediately vaporized into a cloud of chlorine gas that engulfed the accident area to a radius of at least 700 feet before drifting away from the site. Three persons, including the conductor of the UP train and two local residents, died as a result of chlorine gas inhalation. The UP train engineer, 23 civilians, and 6 emergency responders were treated for respiratory distress or other injuries related to the collision and derailment. Damages to rolling stock, track, and signal equipment were estimated at $5.7 million, with environmental cleanup costs estimated at $150,000. The safety issues discussed in this report are train crew fatigue and the vulnerability, under current operating practices, of railroad tank cars carrying hazardous materials. As a result of its investigation, the National Transportation Safety Board makes safety recommendations to the Federal Railroad Administration, the Union Pacific Railroad, the Brotherhood of Locomotive Engineers and Trainmen, and the United Transportation Union. In addition, the Safety Board reiterates six safety recommendations previously issued to the Federal Railroad Administration. KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Hazardous materials KW - Railroad crashes KW - Railroad safety KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0603.pdf UR - https://trid.trb.org/view/898514 ER - TY - RPRT AN - 01095891 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-23 PY - 2006/06/29 SP - 16p AB - This safety recommendation, addressed to the Honorable Edwin G. Foulke, Jr., Assistant Secretary of Labor, U.S. Department of Labor, Occupational Safety and Health Administration, addresses the inconsistency in regulatory requirements and guidance concerning falsework, bracing, and related temporary construction affecting highway construction contractors. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of a passenger vehicle collision with a fallen overhead bridge girder that occurred in Golden, Colorado, on May 15, 2004, resulting in three fatalities. The NTSB makes the following recommendation to the Occupational Safety and Health Administration: (H-06-23) Work with the Federal Highway Administration and the American Association of State Highway and Transportation Officials to make consistent and compatible your organizations' regulatory requirements for and guidance to construction contractors concerning the design and certification of falsework, formwork, and bracing for the erection of highway structures, including the regulations and guidance concerning the need to have the designs prepared or approved by a Registered Professional Engineer. KW - American Association of State Highway and Transportation Officials KW - Bracing KW - Certification KW - Construction KW - Construction management KW - Contractors KW - Crash investigation KW - Design KW - Falsework KW - Fatalities KW - Formwork KW - Girders KW - Guidelines KW - Overpasses KW - Recommendations KW - Regulations KW - U.S. Federal Highway Administration KW - U.S. Occupational Safety and Health Administration UR - https://trid.trb.org/view/855857 ER - TY - RPRT AN - 01095890 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-25 and -26 PY - 2006/06/29 SP - 19p AB - These safety recommendations, addressed to Mr. John Horsley, Executive Director, American Association of State Highway and Transportation Officials, address the inconsistency in regulatory requirements and guidance concerning falsework, bracing, and related temporary construction affecting highway construction contractors, and State oversight of highway contractors and subcontractors. The recommendations are derived from the National Transportation Safety Board's (NTSB's) investigation of a passenger vehicle collision with a fallen overhead bridge girder that occurred in Golden, Colorado, on May 15, 2004, resulting in three fatalities. The NTSB makes the following recommendations to the American Association of State Highway and Transportation Officials: (H-06-25) Work with the Federal Highway Administration and the Occupational Safety and Health Administration to make consistent and compatible your organizations' regulatory requirements for and guidance to construction contractors concerning the design and certification of falsework, formwork, and bracing for the erection of highway structures, including the regulations and guidance concerning the need to have the designs prepared or approved by a Registered Professional Engineer; and (H-06-26) Revise the guidance in your "Construction Manual for Highway Construction" that pertains to the role of State highway and transportation departments' supervisory construction personnel to ensure active supervision and monitoring of safety-critical work being accomplished by contract workers. At a minimum, the guidance should call for State supervisory personnel to 1) prequalify all subcontractors performing safety-critical work on highway projects; 2) require the contractor or subcontractor to submit a written plan or design drawings for all construction, including temporary falsework and bracing, and to have these plans or drawings reviewed and approved by a Registered Professional Engineer; 3) intervene when the contractor or subcontractor exhibits a lack of competence; and 4) require the contractor or subcontractor to take reasonable precautions to monitor and ensure the continued stability of temporary bracing or falsework until permanent construction is completed. KW - American Association of State Highway and Transportation Officials KW - Bracing KW - Certification KW - Construction KW - Construction management KW - Contractors KW - Crash investigation KW - Design KW - Falsework KW - Fatalities KW - Formwork KW - Girders KW - Guidelines KW - Overpasses KW - Oversight KW - Recommendations KW - Regulations KW - State departments of transportation KW - Subcontractors KW - U.S. Federal Highway Administration KW - U.S. Occupational Safety and Health Administration UR - https://trid.trb.org/view/855856 ER - TY - RPRT AN - 01095889 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-24 PY - 2006/06/29 SP - 15p AB - This safety recommendation, addressed to Mr. Thomas E. Norton, Executive Director, Colorado Department of Transportation, addresses State oversight of highway contractors and subcontractors. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of a passenger vehicle collision with a fallen overhead bridge girder that occurred in Golden, Colorado, on May 15, 2004, resulting in three fatalities. The NTSB makes the following recommendation to the Colorado Department of Transportation: (H-06-24) Require your State highway and transportation department supervisory construction personnel to actively supervise and monitor safety-critical work being accomplished by contract workers. As a minimum, State supervisory personnel should 1) prequalify all subcontractors performing safety-critical work on highway projects and 2) intervene when a contractor or subcontractor exhibits a lack of competence. KW - Bracing KW - Colorado Department of Transportation KW - Construction KW - Construction management KW - Contractors KW - Crashes KW - Design KW - Falsework KW - Fatalities KW - Formwork KW - Girders KW - Monitoring KW - Overpasses KW - Recommendations KW - Subcontractors KW - Supervision UR - https://trid.trb.org/view/855854 ER - TY - RPRT AN - 01095888 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-22 PY - 2006/06/29 SP - 15p AB - This safety recommendation, addressed to the Honorable J. Richard Capka, Administrator, Federal Highway Administration, addresses the inconsistency in regulatory requirements and guidance concerning falsework, bracing, and related temporary construction affecting highway construction contractors. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of a passenger vehicle collision with a fallen overhead bridge girder that occurred in Golden, Colorado, on May 15, 2004, resulting in three fatalities. The NTSB makes the following recommendation to the Federal Highway Administration: (H-06-22) Take the lead in working with the Occupational Safety and Health Administration and the American Association of State Highway and Transportation Officials to make consistent and compatible your organizations' regulatory requirements for and guidance to construction contractors concerning the design and certification of falsework, formwork, and bracing for the erection of highway structures, including the regulations and guidance concerning the need to have the designs prepared or approved by a Registered Professional Engineer. KW - American Association of State Highway and Transportation Officials KW - Bracing KW - Certification KW - Construction KW - Construction management KW - Contractors KW - Crash investigation KW - Design KW - Falsework KW - Fatalities KW - Formwork KW - Girders KW - Guidelines KW - Overpasses KW - Recommendations KW - Regulations KW - U.S. Federal Highway Administration KW - U.S. Occupational Safety and Health Administration UR - https://trid.trb.org/view/855852 ER - TY - RPRT AN - 01095887 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-21 PY - 2006/05/08 SP - 5p AB - This safety recommendation, addressed to Mr. Patrick Jones, Executive Director, International Bridge, Tunnel and Turnpike Association, addresses toll plaza design and the lack of national standards for toll plaza design. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of the October 1, 2003, multivehicle collision on the approach to the Hampshire–Marengo toll plaza near Hampshire, Illinois. The NTSB makes the following recommendation to the International Bridge, Tunnel and Turnpike Association: (H-06-21) Cooperate with the Federal Highway Administration and the American Association of State Highway and Transportation Officials to develop written guidelines on toll plaza design that provide information on current tolling practices, electronic toll collection strategies, and other equipment designed to eliminate queuing at toll plazas and to improve toll road safety. KW - American Association of State Highway and Transportation Officials KW - Automated toll collection KW - Design KW - Guidelines KW - Highway traffic control KW - International Bridge, Tunnel and Turnpike Association KW - Multiple vehicle crashes KW - Rear end crashes KW - Recommendations KW - Toll plazas KW - Traffic flow KW - Traffic queuing KW - Traffic safety KW - U.S. Federal Highway Administration UR - https://trid.trb.org/view/855849 ER - TY - RPRT AN - 01095886 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-19 and -20 PY - 2006/05/08 SP - 5p AB - These safety recommendations, addressed to Mr. John Horsley, Executive Director, American Association of State Highway and Transportation Officials, address toll plaza design and the lack of national standards for toll plaza design. The recommendations are derived from the National Transportation Safety Board's (NTSB's) investigation of the October 1, 2003, multivehicle collision on the approach to the Hampshire–Marengo toll plaza near Hampshire, Illinois. The NTSB makes the following recommendations to the American Association of State Highway and Transportation Officials: (H-06-19) Cooperate with the Federal Highway Administration and the International Bridge, Tunnel and Turnpike Association to develop written guidelines on toll plaza design that provide information on current tolling practices, electronic toll collection strategies, and other equipment designed to eliminate queuing at toll plazas and to improve toll road safety; and (H-06-20) Include the information from the written guidelines on toll plaza design in the next update of "A Policy on Geometric Design of Highways and Streets" (Green Book). KW - AASHTO Green Book KW - American Association of State Highway and Transportation Officials KW - Automated toll collection KW - Design KW - Guidelines KW - Highway traffic control KW - International Bridge, Tunnel and Turnpike Association KW - Multiple vehicle crashes KW - Rear end crashes KW - Recommendations KW - Toll plazas KW - Traffic flow KW - Traffic queuing KW - Traffic safety KW - U.S. Federal Highway Administration UR - https://trid.trb.org/view/855847 ER - TY - RPRT AN - 01095885 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-18 PY - 2006/05/08 SP - 4p AB - This safety recommendation, addressed to Mr. J. Richard Capka, Acting Administrator, Federal Highway Administration, addresses the safety hazard of backups at toll plazas. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of the October 1, 2003, multivehicle collision on the approach to the Hampshire–Marengo toll plaza near Hampshire, Illinois. The NTSB makes the following recommendation to the Federal Highway Administration: (H-06-18) Cooperate with the American Association of State Highway and Transportation Officials and the International Bridge, Tunnel and Turnpike Association to develop written guidelines on toll plaza design that provide information on current tolling practices, electronic toll collection strategies, and other equipment designed to eliminate queuing at toll plazas and to improve toll road safety. KW - American Association of State Highway and Transportation Officials KW - Automated toll collection KW - Design KW - Guidelines KW - Highway traffic control KW - International Bridge, Tunnel and Turnpike Association KW - Multiple vehicle crashes KW - Rear end crashes KW - Recommendations KW - Toll plazas KW - Traffic flow KW - Traffic queuing KW - Traffic safety KW - U.S. Federal Highway Administration UR - https://trid.trb.org/view/855846 ER - TY - RPRT AN - 01095884 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-17 PY - 2006/05/08 SP - 5p AB - This safety recommendation, addressed to Mr. Warren E. Hoemann, Acting Administrator, Federal Motor Carrier Safety Administration (FMCSA), addresses FMCSA's process for monitoring passenger carriers that have lost operating authority to verify that they are no longer providing for-hire interstate charter services to the public. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of the October 1, 2003, multivehicle collision on the approach to the Hampshire–Marengo toll plaza near Hampshire, Illinois. The NTSB makes the following recommendation to the FMCSA: (H-06-17) Establish a program to verify that motor carriers have ceased operations after the effective date of revocation of operating authority. KW - Buses KW - Charter operations KW - Monitoring KW - Multiple vehicle crashes KW - Operating authority revocation KW - Recommendations KW - U.S. Federal Motor Carrier Safety Administration UR - https://trid.trb.org/view/855845 ER - TY - RPRT AN - 01095883 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-16 PY - 2006/05/08 SP - 5p AB - This safety recommendation, addressed to the Honorable Norman Y. Mineta, Secretary, U.S. Department of Transportation, addresses heavy truck aggressivity. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of the October 1, 2003, multivehicle collision on the approach to the Hampshire–Marengo toll plaza near Hampshire, Illinois. The NTSB makes the following recommendation to the U.S. Department of Transportation: (H-06-16) Include heavy vehicles in your research, testing, and eventual rulemaking on highway vehicle incompatibility, especially as that incompatibility affects the severity of accidents. KW - Crash severity KW - Heavy duty trucks KW - Heavy vehicles KW - Multiple vehicle crashes KW - Recommendations KW - U.S. Department of Transportation KW - Vehicle aggressiveness KW - Vehicle incompatibility UR - https://trid.trb.org/view/855844 ER - TY - RPRT AN - 01095882 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation: H-06-15 PY - 2006/05/08 SP - 5p AB - This safety recommendation, addressed to the Honorable Samuel W. Bodman, Secretary, U.S. Department of Energy, addresses heavy truck aggressivity. The recommendation is derived from the National Transportation Safety Board's (NTSB's) investigation of the October 1, 2003, multivehicle collision on the approach to the Hampshire–Marengo toll plaza near Hampshire, Illinois. The NTSB makes the following recommendation to the U.S. Department of Energy as the lead department for the Federal research and development component of the 21st Century Truck Program: (H-06-15) Report to the NTSB the 21st Century Truck Program's plans and timetable for prioritizing research, testing, and design enhancements that address heavy truck aggressivity. KW - 21st Century Truck Program KW - Heavy duty trucks KW - Heavy vehicles KW - Multiple vehicle crashes KW - Recommendations KW - U.S. Department of Energy KW - Vehicle aggressiveness UR - https://trid.trb.org/view/855843 ER - TY - RPRT AN - 01029277 AU - National Transportation Safety Board TI - Highway Accident Report: Multivehicle Collision on Interstate 90, Hampshire–Marengo Toll Plaza, Near Hampshire, Illinois, October 1, 2003 PY - 2006/04/18 SP - 96p AB - On October 1, 2003, a multivehicle accident occurred on the approach to an Interstate 90 toll plaza near Hampshire, Illinois. About 2:57 p.m., a 1995 Freightliner tractor-trailer chassis and cargo container combination unit was traveling eastbound on the interstate, approaching the Hampshire–Marengo toll plaza at milepost 41.6, when it struck the rear of a 1999 Goshen GC2 25-passenger specialty bus. As both vehicles moved forward, the specialty bus struck the rear of a 2000 Chevrolet Silverado 1500 pickup truck, which was pushed into the rear of a 1998 Ford conventional tractor-box trailer. As its cargo container and chassis began to overturn, the Freightliner also struck the upper portion of the pickup truck’s in-bed camper and the rear left side of the Ford trailer. The Freightliner and the specialty bus continued forward and came to rest in the median. The pickup truck was then struck by another eastbound vehicle, a 2000 Kenworth tractor with Polar tank trailer. Eight specialty bus passengers were fatally injured, and 12 passengers sustained minor-to-serious injuries. The bus driver, the pickup truck driver, and the Freightliner driver received minor injuries. The Ford driver and codriver and the Kenworth driver were not injured. Major safety issues identified in this investigation include toll plaza design and the lack of national standards for toll plaza design, Federal Motor Carrier Safety Administration oversight of passenger motor carriers operating on revoked authority, collision warning system performance standards and requirements for new commercial vehicles, and vehicle incompatibility and heavy truck aggressivity. As a result of this accident investigation, the Safety Board makes recommendations to the U.S. Department of Energy, the U.S. Department of Transportation, the Federal Motor Carrier Safety Administration, the Federal Highway Administration, the American Association of State Highway and Transportation Officials, and the International Bridge, Tunnel and Turnpike Association. The Safety Board reiterates two recommendations to the National Highway Traffic Safety Administration. KW - Chassis KW - Containers KW - Crash avoidance systems KW - Crash reports KW - Fatalities KW - Hampshire (Illinois) KW - Highway design KW - Highway safety KW - Injuries KW - Interstate highways KW - Motor carriers KW - Multiple vehicle crashes KW - Oversight KW - Performance KW - Pickup trucks KW - Recommendations KW - Revoked authority KW - Special purpose buses KW - Standards KW - Tank trailers KW - Toll plazas KW - Tractor trailer combinations KW - Trucks KW - U.S. Federal Motor Carrier Safety Administration KW - Vehicle incompatibility KW - Warning systems UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0603.pdf UR - https://trid.trb.org/view/786293 ER - TY - RPRT AN - 01026342 AU - National Transportation Safety Board TI - Marine Accident Report: Capsizing of U.S. Small Passenger Vessel Lady D, Northwest Harbor, Baltimore, Maryland March 6, 2004 PY - 2006/03/07 SP - 124p AB - On March 6, 2004, the small passenger vessel Lady D, a pontoon water taxi with 2 crewmembers and 23 passengers on board, was en route from Fort McHenry to Fells Point, Maryland, when it encountered a rapidly developing storm with high winds. The pontoon vessel began to roll in the waves and eventually continued over onto its starboard side and capsized. Responders were able to rescue or recover all but 3 occupants of the Lady D and transport them to area hospitals within an hour of the accident. The bodies of the remaining victims were recovered from the waterway on March 14 and 15. As a result of this accident, 5 passengers died; 4 passengers suffered serious injuries; and 12 people sustained minor injuries. Major safety issues discussed in this report include passenger weight criteria for stability assessment; pontoon vessel stability standards; and policies and procedures pertaining to weather operations. As a result of its investigation of this accident, the Safety Board made safety recommendations to the U. S. Coast Guard. KW - Baltimore (Maryland) KW - Capsizing KW - Emergency management KW - Emergency response time KW - Fatalities KW - Injuries KW - Marine safety KW - Passengers KW - Policy KW - Pontoon boats KW - Procedures KW - Recommendations KW - Small passenger vessels KW - Stability (Mechanics) KW - Standards KW - Storms KW - United States Coast Guard KW - Water transportation crashes KW - Water waves KW - Weather conditions KW - Weight KW - Wind UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0601.pdf UR - https://trid.trb.org/view/783188 ER - TY - RPRT AN - 01023421 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. Air Carrier Operations, Calendar Year 2001 PY - 2006/02/14 SP - 61p AB - The National Transportation Safety Board’s Annual Review of Aircraft Accident Data: U.S. Air Carrier Operations is a statistical review of U.S. commercial aviation accidents that occurred in calendar year 2001. In addition to accident statistics, the review provides general economic and aviation industry indicators that may have influenced aircraft activity during the year. Accident data for the 9 years preceding calendar year 2001 provide an historical context. KW - Aerospace industry KW - Air transportation crashes KW - Aircraft operations KW - Airlines KW - Annual reviews KW - Aviation safety KW - Civil aircraft KW - Civil aviation KW - Crash data KW - Economic indicators KW - Statistics KW - United States UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARC06-01.pdf UR - https://trid.trb.org/view/780513 ER - TY - RPRT AN - 01029285 AU - National Transportation Safety Board TI - Highway Accident Report: Collision Between a Ford Dump Truck and Four Passenger Cars, Glen Rock, Pennsylvania, April 11, 2003 PY - 2006/02/07 SP - 78p AB - About 3:36 p.m. on April 11, 2003, in the Borough of Glen Rock, Pennsylvania, a 1995 Ford dump truck owned and operated by Blossom Valley Farms, Inc., was traveling southbound on Church Street, a two-lane, two-way residential street with a steep downgrade, when the driver found that he was unable to stop the truck. The truck struck four passenger cars, which were stopped at the intersection of Church and Main Streets, and pushed them into the intersection. One of the vehicles struck three pedestrians (a 9-year-old boy, a 7-year-old boy, and a 7-year-old girl), who were on the sidewalk on the west side of Church Street. The truck continued across the intersection, through a gas station parking lot, and over a set of railroad tracks before coming to rest about 300 feet south of the intersection. As a result of the collision, the driver and an 11-year-old occupant of one of the passenger cars received fatal injuries, and the three pedestrians who were struck received minor-to-serious injuries. The six remaining passenger car occupants and the truck driver were not injured. Major safety issues identified in this report include maintaining air brakes equipped with automatic slack adjusters, the knowledge and skills needed to drive air brake-equipped vehicles, and motor carrier oversight. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Federal Motor Carrier Safety Administration, the 50 States and the District of Columbia, the Commercial Vehicle Safety Alliance, manufacturers and marketers of automatic slack adjusters, manufacturers of vehicles equipped with air brakes, the National Institute for Automotive Service Excellence (ASE), and publishers of ASE certification test study guides. KW - Abilities KW - Air brakes KW - Borough of Glen Rock (Pennsylvania) KW - Children KW - Crash investigation KW - Crash reports KW - Dump trucks KW - Fatalities KW - Highway safety KW - Injuries KW - Knowledge KW - Pedestrian safety KW - Pedestrian-vehicle crashes KW - Private passenger vehicles KW - Recommendations KW - Sidewalks KW - Traffic crashes KW - Traffic safety KW - Truck drivers KW - Vehicle maintenance KW - Vehicle occupants UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0601.pdf UR - https://trid.trb.org/view/786305 ER - TY - RPRT AN - 01029257 AU - National Transportation Safety Board TI - Highway Accident Report: Passenger Vehicle Median Crossover and Head-On Collision With Another Passenger Vehicle, Linden, New Jersey, May 1, 2003 PY - 2006/02/07 SP - 52p AB - On May 1, 2003, about 2:11 a.m., eastern daylight time, a 1998 Mercedes Benz CLK320, driven by a 34-year-old off-duty police officer, was traveling southbound on U.S. Route 1 through the city of Linden in Union County, New Jersey. The vehicle was traveling in the right lane of a six-lane divided highway. The weather was clear, and the roadway was dry, except for a puddle of water adjacent to a service station on the west side of the roadway. Near milepost 41.4, the Mercedes, traveling 48 to 62 mph, hit the curb on the west side of the road and swerved to the left. The Mercedes crossed the other two southbound lanes; mounted and crossed an 11.5-foot-wide, 6-inch-high raised concrete curb median; and entered the northbound lanes, where it collided head on with a 1986 Ford Taurus traveling in the left northbound lane. The Mercedes rolled up and over the Ford and landed on its roof. The Mercedes slid approximately 80 feet across the northbound lanes and struck a wooden utility pole next to the east side of the roadway, where it came to rest straddling the right northbound lane and the grassy area to the east of the roadway. Following the collision, the Ford remained upright, rotated about 163 degrees counterclockwise, and slid about 50 feet, where it came to rest in the right northbound lane. The Ford was occupied by a 33-year-old driver and four passengers ranging in age from 18 to 31. The drivers of both vehicles and three of the four Ford Taurus passengers died at the scene. The fourth Ford passenger died several hours later in a hospital. Major safety issues identified in this report are alcohol impairment, speed enforcement, and evaluative criteria for median barrier installation. As a result of its investigation, the Safety Board makes safety recommendations to the Federal Highway Administration, the city of Linden, and the American Association of State Highway and Transportation Officials. The Safety Board also reiterates a previously issued recommendation to the State of New Jersey. KW - Crash reports KW - Criteria KW - Cross median accidents KW - Divided highways KW - Drunk drivers KW - Drunk driving KW - Evaluation KW - Fatalities KW - Frontal crashes KW - Highway safety KW - Installation KW - Linden (New Jersey) KW - Median barriers KW - Private passenger vehicles KW - Recommendations KW - Rollover crashes KW - Six lane highways KW - Speed KW - Traffic crashes KW - Traffic law enforcement KW - Traffic safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0602.pdf UR - https://trid.trb.org/view/786294 ER - TY - RPRT AN - 01100370 AU - National Transportation Safety Board TI - Annual Review of Aircraft Accident Data: U.S. General Aviation, Calendar Year 2002 PY - 2006 SP - 60p AB - The National Transportation Safety Board’s 2002 Annual Review of Aircraft Accident Data for U.S. General Aviation is a statistical compilation and review of general aviation accidents that occurred in 2002 involving U.S.-registered aircraft. As a summary of all U.S. general aviation accidents for 2002, the review is designed to inform general aviation pilots and their passengers and to provide detailed information to support future government, industry, and private research efforts and safety improvement initiatives. KW - Air transportation crashes KW - Aviation safety KW - Crash data KW - General aviation KW - General aviation aircraft KW - Trend (Statistics) KW - United States UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARG06-02.pdf UR - https://trid.trb.org/view/859508 ER - TY - JOUR AN - 01036505 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Price, Jana AU - Southworth, James A TI - Positive Train Control Systems PY - 2006 VL - 2 IS - 1 SP - pp 75-79 AB - This article provides an overview of a symposium on positive train control (PTC) systems that was hosted by the National Transportation Safety Board in March 2005. The goal of the symposium was to reinvigorate dialogue regarding issues relevant to the implementation of PTC systems. More than 150 people participated in the symposium, including representatives from the railroad industry, equipment manufacturers and government regulators. The symposium was organized a series of presentations followed by panel discussions and open question-and-answer sessions. Most of the railroad industry presenters described their organizations' ongoing efforts to develop, test and implement PTC systems. The Federal Railroad Administration described its role in the development of PTC systems, provided an overview of the use of the Nationwide Differential Global Positioning System in PTC systems and summarized its ongoing research to understand PTC human performance issues. Other presenters included representatives from PTC manufacturers and industry consultants. KW - Conferences KW - Equipment KW - Global Positioning System KW - Governments KW - Human factors KW - Implementation KW - Industries KW - Positive train control KW - Product development KW - Railroad safety KW - Railroads KW - Research KW - Testing KW - U.S. Federal Railroad Administration KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/793009 ER - TY - JOUR AN - 01036488 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Coury, Bruce G TI - Personal Flotation Devices in Recreational Boating PY - 2006 VL - 2 IS - 1 SP - pp 67-74 AB - The National Transportation Safety Board (NTSB) recently sponsored a forum on personal flotation devices (PFD) in recreational boating. This article summarizes the proceedings of this forum. The forum covered a range of topics including adult and child PFD use, accident and injury risk factors, boating education and operator licensing, with much of the discussion focusing on the merits of a mandatory PFD wear requirement for adults in recreational boats. The fifteen presentations were divided into four panels: (1) facts, figures and studies of PFD use; (2) public safety perspectives; (3) recreational boater perspective; and (4) recreational boating manufacturer perspective. Many participants felt that a mandatory adult PFD requirement would not be acceptable to the recreational boating community, and suggested alternatives for increasing PFD use. The insights provided by the forum prompted the NTSB to take action by issuing four safety recommendations in the following areas: implementing a more effective risk assessment program for recreational boating; collecting data on boaters, boats and boating activities; improving boater education; and increasing industry efforts to promote PFD use. KW - Adults KW - Boaters KW - Boating KW - Children KW - Conferences KW - Crash risk forecasting KW - Data collection KW - Industries KW - Licensing KW - Life preservers KW - Maritime safety KW - Regulation KW - Risk assessment KW - Safety education KW - Statistics KW - U.S. National Transportation Safety Board KW - Water transportation crashes UR - https://trid.trb.org/view/793007 ER - TY - JOUR AN - 01036024 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Park, Alice AU - Spangler, Christy L TI - Developing Animations to Support Complex Aviation Accident Investigations PY - 2006 VL - 2 IS - 1 SP - pp 23-30 AB - In their quest to find the probable cause of airplane accidents and ensure public safety, National Transportation Safety Board engineers and investigators collect and analyze a variety of complex data that may be difficult to visualize or explain to a nontechnical audience. The NTSB uses three-dimensional graphics and animations to show what happened during the accident and to illustrate the engineering work performed to reconstruct the accident sequence. This paper describes how animation can be used to support complex aviation accident investigations. This discussion focuses on two accidents: American Airlines flight 587 in 2001 and Air Midwest flight 5481 in 2003. Animations used to convey complex accident investigation data must incorporate simplicity, elegance and scale of design. Engineers and animators work closely together to achieve this result by carefully crafting a storyboard that lays out the data to tell a clear and coherent story. Such animations must be based on data that has been scrupulously measured, recorded and calculated to ensure accuracy. KW - Air Midwest Flight 5481 KW - Air transportation crashes KW - American Airlines Flight 587 KW - Case studies KW - Computer animation KW - Computer graphics KW - Crash data KW - Crash investigation KW - Design KW - Engineering KW - Three dimensional imaging KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/793003 ER - TY - JOUR AN - 01036023 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Poland, Kristin M AU - McCray, Linda B AU - Barsan-Anelli, Aida TI - Occupant Safety in Large School Buses: Crash Investigations, Testing, and Modeling PY - 2006 VL - 2 IS - 1 SP - pp 55-66 AB - This paper summarizes work accomplished by both the National Transportation Safety Board (NTSB) and the National Highway Traffic Safety Administration (NHTSA) to address the safety of large school buses. The main focus is to review large school bus crashworthiness and the role of compartmentalization in protecting occupants. Reviews of recent crash investigations, full scale crash tests, sled tests and simulation modeling are included. The NTSB's accident investigations indicate that in severe accidents, injuries and fatalities do result and that simple changes in the occupant protection systems may not be enough to protect occupants in these crashes. NHTSA's work indicates that most occupants receive good protection from compartmentalization alone in both front and side impact collisions. However, the results of NHTSA's research program have shown that lap/shoulder belt systems produce lower dummy head and neck injury measures than compartmentalization and lap belt systems. However, potential negative consequences of lap/shoulder belt systems have not yet been adequately researched to allow a full determination of overall costs/benefits. KW - Compartmentalization KW - Crash investigation KW - Crashworthiness KW - Impact tests KW - Occupant protection devices KW - Safety engineering KW - School buses KW - Simulation KW - Sled tests KW - U.S. National Highway Traffic Safety Administration KW - U.S. National Transportation Safety Board KW - Vehicle tests UR - https://trid.trb.org/view/793006 ER - TY - JOUR AN - 01036009 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Simpson, Charles H TI - Transportation Safety Board of Canada Investigation Information Management System PY - 2006 VL - 2 IS - 1 SP - pp 5-7 AB - The Transportation Safety Board of Canada (TSB) has the sole authority under Canadian law to conduct safety investigations into occurrences in the rail, marine, air and pipeline industries, to collect and analyze the facts and to convey the resulting information via investigation reports and recommendations. Since the primary products of the TSB are knowledge and information, excellence in how information is gathered, employed, stored and distributed is fundamental to achieving TSB's mandate. This article describes a project to develop an integrated information management/ information technology platform to support TSB and its investigation teams. Known as the TSB Investigation Information Management System (TIMMS), the goal is to implement an integrated set of documents, content, records, cases, workflow, forms, and project management practices and tools. The system will also feature a reference center to consolidate policies, guidelines, manuals, checklists and other reference tools into a single area for easier access. The project has already faced and surmounted several obstacles during its development, including both technical and organizational issues. The objective is to have the first version of the system in operation by March 2006. KW - Air transportation crashes KW - Crash data KW - Crash investigation KW - Crash records KW - Crash reports KW - Information management KW - Information storage and retrieval systems KW - Information technology KW - Integrated systems KW - Management information systems KW - Pipeline safety KW - Product development KW - Railroad crashes KW - Transportation Safety Board of Canada KW - Water transportation crashes UR - https://trid.trb.org/view/792992 ER - TY - JOUR AN - 01035985 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Gregor, Joseph A TI - A Mathematical Cross-Correlation for Time-Alignment of Cockpit Voice Recorder and Flight Data Recorder Data PY - 2006 VL - 2 IS - 1 SP - pp 43-53 AB - A new method is described for performing timing correlations between flight data recorder (FDR) and cockpit voice recorder (CVR) information. This method involves the use of the cross-correlation function to search the typically larger FDR data file for a best match to the event pattern present in the CVR data file. The results of this search give a first-order estimate of the time differential between identical events as recorded on both units. A simple curve fit may then be employed to obtain a general conversion from time as represented in the CVR and time as represented in the FDR. KW - Cockpit voice recorders KW - Correlation analysis KW - First order equations KW - Flight recorders KW - Information processing KW - Mathematical methods KW - Time KW - Timing UR - https://trid.trb.org/view/793005 ER - TY - JOUR AN - 01035982 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Fox, Matthew R AU - Schultheisz, Carl R AU - Reeder, James R AU - Jensen, Brian J TI - Materials Examination of the Vertical Stabilizer from American Airlines Flight 587 PY - 2006 VL - 2 IS - 1 SP - pp 9-22 AB - The first in-flight failure of a primary structural component made from composite material on a commercial airplane led to the crash of American Airlines flight 587. As part of the National Transportation Safety Board investigation of the accident, the composite materials of the vertical stabilizer were tested, microstructure was analyzed and fractured composite lugs that attached the vertical stabilizer to the aircraft tail were examined. This paper discusses the materials testing and analysis, the composite fractures, and resulting clues to the failure events. Findings show that the vertical stabilizer performed in a manner that was consistent with its design and certification. The vertical stabilizer fractured from the fuselage in overstress, starting with the right rear lug while the vertical stabilizer was exposed to aerodynamic loads that were more than certified ultimate load design envelope and approximately twice the certified limit load design envelope. KW - Aerodynamics KW - Air transportation crashes KW - Aircraft structural components KW - American Airlines Flight 587 KW - Composite materials KW - Crash investigation KW - Fracture mechanics KW - Fracture properties KW - Fracture tests KW - Lugs KW - Materials tests KW - Microstructure KW - Stresses KW - U.S. National Transportation Safety Board KW - Ultimate load design KW - Vertical stabilizers UR - https://trid.trb.org/view/793001 ER - TY - JOUR AN - 01035958 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Grossi, Dennis R TI - Aviation Recorder Overview PY - 2006 VL - 2 IS - 1 SP - pp 31-42 AB - A wide variety of airborne and ground-based aviation recording devices are available that can provide vital information for accident prevention purposes. This paper gives an overview of the evolution of flight recorder technology and regulatory requirements, and describes the capabilities and limitations of the various types of recorded information available fro accident/incident investigation and accident prevention. Although the first flight recorders were introduced over 40 years ago, the data provided by these early recorders were limited and of poor quality. One of the most significant changes in recorder technology occurred in the early 1970s with the introduction of digital recorders. The amount and quality of data provided by these recorders gave accident investigators their first opportunity to purse an in-depth evaluation of the facts, conditions and circumstances surrounding an occurrence. The introduction of digital avionics and fly-by-wire technologies in the 1980s provided investigators with both challenges and opportunities. This new technology eliminated some well-established investigative techniques and offered so much information that early-model digital flight data recorders were overwhelmed. The advent of solid-state recorders resolved many of these problems while improving survivability and reliability. KW - Air transportation crashes KW - Automatic data collection systems KW - Aviation safety KW - Avionics KW - Crash data KW - Crash investigation KW - Data collection KW - Digital computers KW - Flight recorders KW - Fly by wire KW - History KW - Regulations KW - Reliability KW - Solid state devices KW - Technological innovations UR - https://trid.trb.org/view/793004 ER - TY - RPRT AN - 01139219 AU - National Transportation Safety Board TI - Railroad Accident Report: Collision of Norfolk Southern Freight Train 192 With Standing Norfolk Southern Local Train P22 With Subsequent Hazardous Materials Release at Graniteville, South Carolina, January 6, 2005 PY - 2005/11/29 SP - 68p AB - About 2:39 a.m. eastern standard time on January 6, 2005, northbound Norfolk Southern Railway Company (NS) freight train 192, while traveling about 47 mph through Graniteville, South Carolina, encountered an improperly lined switch that diverted the train from the main line onto an industry track, where it struck an unoccupied, parked train (NS train P22). The collision derailed both locomotives and 16 of the 42 freight cars of train 192, as well as the locomotive and 1 of the 2 cars of train P22. Among the derailed cars from train 192 were three tank cars containing chlorine, one of which was breached, releasing chlorine gas. The train engineer and eight other people died as a result of chlorine gas inhalation. About 554 people complaining of respiratory difficulties were taken to local hospitals. Of these, 75 were admitted for treatment. Because of the chlorine release, about 5,400 people within a 1-mile radius of the derailment site were evacuated for several days. Total damages exceeded $6.9 million. The safety issues addressed in the report are railroad accidents attributable to improperly lined switches and the vulnerability, under current operating practices, of railroad tank cars carrying hazardous materials. As a result of its investigation of this accident, the Safety Board makes recommendations to the Federal Railroad Administration. KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Hazardous materials KW - Railroad crashes KW - Railroad safety KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0504.pdf UR - https://trid.trb.org/view/898515 ER - TY - RPRT AN - 01029231 AU - National Transportation Safety Board TI - Highway Accident Report: Multiple Vehicle Collision on Interstate 95, Fairfield, Connecticut, January 17, 2003 PY - 2005/11/16 SP - 80p AB - On Interstate 95 (I-95) near Fairfield, Connecticut, two consecutive accidents occurred within 11 minutes in the early morning hours of January 17, 2003. At the time of the accidents, light snow was falling, the roads were wet and icy, and snow covered the roadway shoulders. About 4:50 a.m., a 1996 Freightliner tractor flatbed semitrailer was involved in a nonfatal multivehicle accident. The truck was traveling in a work zone on I-95 north, near milepost 26.6, at a driver-estimated speed of 50 mph, when it slid out of control. The vehicle entered the median, overturned and overrode the portable concrete barrier, and collided with a southbound 1997 Dodge Avenger sedan. A southbound 2001 Freightliner tractor/refrigerated trailer combination unit struck the Dodge sedan and then struck the 1996 Freightliner tractor. The three vehicles came to rest blocking the southbound lanes of the highway. During the accident sequence, the flatbed semitrailer separated from the 1996 Freightliner tractor. The semitrailer came to rest perpendicular to the roadway, straddling the portable concrete barrier and partially obstructing the left lane of I-95 north. At 5:01 a.m. a 1999 Chevrolet Tahoe sport utility vehicle--occupied by nine college students and traveling north in the left lane--collided with and underrode the left side corner of the 1996 Freightliner semitrailer. Following the impact, the Chevrolet disengaged from the semitrailer and entered the median, skidded along the concrete barrier, and came to rest about 450 feet to the northeast. The driver and three passengers in the Chevrolet were fatally injured. The surviving occupants were seriously injured. Major safety issues identified in this investigation include the adequacy of snow and ice treatment strategies, lack of specific guidance on the use of high-performance median barriers, placement of portable concrete median barriers, and need for primary seat belt laws for all seating positions. As a result of this accident investigation, the National Transportation Safety Board makes recommendations to the Federal Highway Administration, the Connecticut Department of Transportation, and the American Association of State Highway and Transportation Officials. The Safety Board reiterates a recommendation to the Governor and the legislative leaders of Connecticut. KW - Automobiles KW - College students KW - Concrete barriers KW - Crash investigation KW - Crash reports KW - Fairfield (Connecticut) KW - Fatalities KW - Freightliner KW - High performance KW - Highway safety KW - Icy roads KW - Injuries KW - Interstate highways KW - Location KW - Medians KW - Morning KW - Multiple vehicle crashes KW - Portable equipment KW - Primary seat belt laws KW - Recommendations KW - Snow and ice control KW - Snowfall KW - Sport utility vehicles KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic safety KW - Trailers KW - Underride override crashes KW - Utilization KW - Wet weather KW - Work zones UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0503.pdf UR - https://trid.trb.org/view/786306 ER - TY - RPRT AN - 01013267 AU - National Transportation Safety Board TI - National Transportation Safety Board Highway Accident Brief, Accidents No. HWY-04-FH-015 and HWY-04-MH-038 PY - 2005/10/17 SP - 12p AB - This brief discusses two rear-end, chain-reaction collisions that occurred at the same location near North Hudson, New York. The first accident (Accident No. HWY-04-FH-015) took place on February 22, 2004, and will be referred to as North Hudson I. The second accident (Accident No. HWY-04-MH-038), which will be referred to as North Hudson II, occurred on September 19, 2004. The first accident involved 4 vehicles (a bus, tractor trailer, sport utility vehicle, and automobile) and the second accident involved 5 vehicles (2 tractor trailers, 2 pickup trucks, and an automobile). For both accidents, personnel from the U.S. Department of Homeland Security, U.S. Border Patrol (USBP), were conducting an immigration checkpoint on Interstate 87 (I-87) near North Hudson, New York, about 74 miles south of the Canadian border. Checkpoint operations required vehicles in both southbound traffic lanes to stop for an inspection and a brief driver interview. As a result, traffic became congested on I-87 southbound and had backed up approximately 900 (North Hudson I) or 807 (North Hudson II) feet north of the checkpoint. The National Transportation Safety Board determines that the probable cause of these accidents was the failure of the United States Border Patrol and the New York State Department of Transportation to provide adequate warning of the checkpoint's presence in the southbound lanes of the interstate and to convey a clear, simple message that all vehicular traffic would be required to stop for the checkpoint. Contributing to the North Hudson I accident was the failure of the motorcoach driver to identify the excessive closure rate between his vehicle and the slowed or stopped traffic at the end of the queue. Contributing to the North Hudson II accident was a truck driver's failure to react to the line of stopped vehicles at the checkpoint, most likely caused by degraded cognitive functioning as a result of his obesity-hypoventilation syndrome and sleep deprivation. As a result of the North Hudson I and II accidents, the National Transportation Safety Board issued the following recommendations on October 21, 2004, to the American Association of State Highway and Transportation Officials (AASHTO): (1) H-04-35 Immediately develop, with the assistance of the Federal Highway Administration and the U.S. Bureau of Customs and Border Protection, comprehensive traffic control guidelines specifically tailored to U.S. Border Patrol checkpoints located on high-speed arterial roadway (Urgent); and (2) H-04-36 Assist the Federal Highway Administration in incorporating the guidelines referred to in Safety Recommendation H-04-35 into the Manual on Uniform Traffic Control Devices. KW - Arterial highways KW - Automobiles KW - Buses KW - Chain reactions (Traffic accidents) KW - Cognitive impairment KW - Drivers KW - High speed ground transportation KW - Highway safety KW - Highway traffic control KW - Inspection KW - Interstate highways KW - Interviewing KW - Manual on Uniform Traffic Control Devices KW - North Hudson (New York) KW - Obesity KW - Pickup trucks KW - Rear end crashes KW - Recommendations KW - Security checkpoints KW - Sleep deprivation KW - Sport utility vehicles KW - Stopped traffic KW - Stopping KW - Tractor trailer combinations KW - Traffic congestion KW - Traffic crashes KW - Traffic safety KW - U.S. Border Patrol KW - Warning signs UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0503.pdf UR - https://trid.trb.org/view/767326 ER - TY - RPRT AN - 01014943 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision between the U.S. Navy Submarine USS Greenville and Japanese Motor Vessel Ehime Maru near Oahu, Hawaii, February 9, 2001 PY - 2005/09/29 SP - 59p AB - About 1200 local time on February 9, 2001, the Japanese fishing and training vessel Ehime Maru, with 20 crew members, 13 students, and 2 teachers on board, departed pier 9 in Honolulu, Hawaii, en route to fishing grounds about 300 nautical miles south of Oahu. The area weather predictions for the day included a coastal waters forecast advising caution for the waters south of the islands from Kauai to Maui because isolated thunderstorms to the east were generating strong, gusty 15- to 20-knot winds, which, in turn, were producing waves of 8 to 12 feet. The Ehime Maru was in the middle of a 74-day training voyage that had originated in Japan on January 10. During the vessel's 1-day stopover in Honolulu, its air conditioning system was repaired. The route of the Ehime Maru took it into an area designated by COMSUBPAC3 officials for the conduct of a distinguished visitor cruise, a Navy program that promotes the mission of the service by permitting civilians to observe operations on board its vessels. Various senior Navy officials described the operating location as "not a highly trafficked area" that was "about as safe as can possibly be". The submarine selected to host the visitor cruise was the USS Greeneville, which was one of five Los Angeles-class fast-attack submarines assigned to Submarine Squadron 1 of the U.S. Pacific Fleet, but which had not been in the Pacific Fleet's regular rotational deployment cycle since 1998. The USS Greeneville and the Ehime Maru collided at about 1:43 pm on February 9, 2001. 9 people from the Ehime Maru were killed and 10 people from that vessel were injured. The National Transportation Safety Board determines that the probable cause of the collision of the USS Greeneville with the Japanese fisheries training vessel Ehime Maru was the inadequate interaction and communication among senior members of the combat systems team (the commanding officer, the officer of the deck, the fire control technician, and the sonar supervisor), which resulted in the failure to perform adequate contact analysis and adhere to proper procedures for moving to periscope depth; and the commanding officer's decision to order an emergency surfacing maneuver. Contributing to the cause of the accident was the failure of the crew, in particular the commanding officer, to adequately manage the civilian visitors so that they did not impede operations. Contributing to the loss of life was the rapid flooding and sinking of the Ehime Maru, which occurred when the submarine's rudder tore through the fishing vessel's lower deck spaces. KW - Civilians KW - Commanding officers KW - Communication KW - Crash causes KW - Decision making KW - Depth KW - Fatalities KW - Fishing vessels KW - Floods KW - Hawaii KW - Injuries KW - Marine safety KW - Periscopes KW - Procedures KW - Submarines KW - United States Navy KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0501.pdf UR - https://trid.trb.org/view/771502 ER - TY - RPRT AN - 01014927 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Cargo Fire Involving Lithium-Ion Batteries, Memphis, Tennessee, August 7, 2004 PY - 2005/09/26 SP - 11p AB - About 3:51 a.m., central daylight time, on August 7, 2004, a fire destroyed some freight that included lithium-ion batteries; the freight was in a unit load device (ULD) at the Federal Express Corporation (FedEx Express) hub in Memphis, Tennessee. The ULD had been raised on loading equipment and pushed about halfway onto an airplane bound for Charles de Gaulle Airport, Paris, France, when the loading personnel smelled smoke. They returned the smoking ULD to the loading equipment and lowered the ULD to the ground. When Memphis fire department responders opened the ULD, a fire flared up inside. Damage to the ULD and the freight is estimated as $20,000. The airplane was a Boeing MD-11 that FedEx Express operated as flight 0004. The National Transportation Safety Board determines that the probable cause of the fire in a unit load device at the Federal Express Corporation hub in Memphis, Tennessee, on August 7, 2004, was the failure of the unapproved packaging used by AC Propulsion, Inc., which was inadequate to protect the lithium-ion battery modules from short circuits during transportation. KW - Air cargo KW - Boeing aircraft KW - Crash causes KW - Crashes KW - FedEx Corporation KW - Fire KW - Freight transportation KW - Hazardous materials KW - Lithium batteries KW - Packaging KW - Short circuits KW - Smoke KW - Unit loading devices UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB0501.pdf UR - https://trid.trb.org/view/771559 ER - TY - RPRT AN - 01080583 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Weather Encounter and Subsequent Crash into the Pacific Ocean, Heli-USA Airways, Inc., Aerospatiale AS350BA, N355NT Haena, Hawaii, September 23, 2005 PY - 2005/09/23 SP - 19p AB - On September 23, 2005, about 1415 Hawaiian standard time, an Aerospatiale AS350BA helicopter, N355NT, registered to Jan Leasing, LLC, and operated by Heli- USA Airways, Inc., of Las Vegas, Nevada, encountered adverse weather and crashed into the Pacific Ocean several hundred feet off the coast of Kailiu Point, near Haena, Hawaii, on the island of Kauai. The sightseeing air tour flight was operated under the provisions of 14 Code of Federal Regulations (CFR) Part 135 and visual flight rules (VFR) with a company flight plan in effect. Localized instrument meteorological conditions (IMC) prevailed in the vicinity of the accident site. Three passengers were killed, and the commercial pilot and two other passengers received minor injuries. The flight departed from Lihue Airport (LIH), Lihue, Hawaii, on the island of Kauai, at 1354 for the intended 45-minute tour. The flight was operated under Special Federal Aviation Regulation (SFAR) 71, “Special Operating Rules for Air Tour Operators in the State of Hawaii,” and in accordance with a certificate of waiver or authorization approved for Heli-USA by the Federal Aviation Administration (FAA) Honolulu Flight Standards District Office (FSDO) in Honolulu, Hawaii. The National Transportation Safety Board determines that the probable cause of the accident was the pilot’s decision to continue flight into adverse weather conditions, which resulted in a loss of control due to an encounter with a microburst. Contributing to the accident was inadequate Federal Aviation Administration surveillance of Special Federal Aviation Regulation 71 operating restrictions. Contributing to the loss of life in the accident was the lack of helicopter flotation equipment. KW - Air tours KW - Air transportation crashes KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Fatalities KW - Helicopters KW - Injuries KW - Kauai (Hawaii) KW - Life preservers KW - Loss of control KW - Microbursts KW - Oversight KW - Survival KW - U.S. Federal Aviation Administration KW - Visual flight KW - Weather conditions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0701.pdf UR - https://trid.trb.org/view/839644 ER - TY - RPRT AN - 01014926 AU - National Transportation Safety Board TI - Aircraft Accident Report: Executive Airlines (doing business as American Eagle) Flight 5401, Avions de Transport Regional 72-212, N438AT, San Juan, Puerto Rico, May 9, 2004 PY - 2005/09/07 SP - 119p AB - This report explains the accident involving Executive Airlines (doing business as American Eagle) flight 5401, an Avions de Transport Regional 72-212, which skipped once, bounced hard twice, and then crashed at Luis Muñoz Marin International Airport, San Juan, Puerto Rico. Safety issues discussed in this report focus on flight crew performance, the lack of company bounced landing recovery guidance and training, and malfunctioning flight data recorder potentiometer sensors. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - American Eagle (Airline) KW - Aviation safety KW - Bounced landing KW - Flight crews KW - Flight recorders KW - Landing KW - Luis Muñoz Marin International Airport KW - Performance KW - Potentiometers KW - Recommendations KW - Recovery KW - San Juan (Puerto Rico) KW - Sensors KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0502.pdf UR - https://trid.trb.org/view/771552 ER - TY - RPRT AN - 01016510 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Union Pacific Railroad Train into Crystal Cold Storage Warehouse Maintenance Building in San Antonio, Texas, November 10, 2004 PY - 2005/08/31 SP - 5p AB - On November 10, 2004, about 9:10 a.m., Union Pacific Railroad (UP) train YEY55-10 collided with a track car move and four refrigerated boxcars that were parked at Crystal Cold Storage track in San Antonio, Texas. The engineer lost radio communication with the conductor, who was controlling the train movement, and failed to stop the train in time to avoid the collision. An employee of a rental car company was killed as one of the parked cars was shoved over a pair of wheel stops and into the Crystal Cold Storage maintenance building. A Crystal Cold Storage employee was injured while he was unloading frozen food from one of the parked boxcars. Damages totaled $308,637. The National Transportation Safety Board determines that the probable cause of the Union Pacific Railroad accident was the failure of the engineer to stop the train as required by Union Pacific Railroad radio communication operating rules. KW - Communications KW - Conductors (Trains) KW - Crash causes KW - Crashes KW - Crystal Cold Storage KW - Injuries KW - Locomotive engineers KW - Loss and damage KW - Maintenance facilities KW - Radio KW - Railroad crashes KW - Railroad safety KW - San Antonio (Texas) KW - Stopping KW - Union Pacific Railroad KW - Warehouses UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0505.pdf UR - https://trid.trb.org/view/771681 ER - TY - RPRT AN - 01007235 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-25 and -26 PY - 2005/08/05 SP - 6p AB - These safety recommendations, addressed to the Honorable Jeffrey W. Runge, M.D., Administrator, National Highway Traffic Safety Administration, address the effectiveness of driver education and training programs. The National Transportation Safety Board makes the following recommendations to the National Highway Traffic Safety Administration: (H-05-25) In cooperation with the U.S. Department of Education, review current driver education and training programs in use nationally and internationally and determine which instructional tools, training methods, and curricula are consistent with what the U.S. Department of Education has identified as best teaching methodologies and have led to or are likely to lead to a reduction in crashes. Further, incorporate these best practices into a model driver education and training curriculum; and (H-05-26) In cooperation with the U.S. Department of Education, determine the optimum sequencing, in conjunction with graduated driver licensing qualifications, for educating teenagers on safe driving skills, both in the classroom and behind the wheel, and encourage the States to adopt this requirement. KW - Best practices KW - Curricula KW - Driver education KW - Driver training KW - Graduated licensing KW - Recommendations KW - Teenage drivers KW - Traffic safety KW - U.S. Department of Education KW - U.S. National Highway Traffic Safety Administration UR - https://trid.trb.org/view/763291 ER - TY - RPRT AN - 01007198 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-23 and -24 PY - 2005/08/05 SP - 8p AB - These safety recommendations, addressed to the Honorable Margaret Spellings, Secretary, U.S. Department of Education, address the effectiveness of driver education and training programs. The National Transportation Safety Board makes the following safety recommendations to the U.S. Department of Education: (H-05-23) In cooperation with the National Highway Traffic Safety Administration, review current driver education and training programs in use nationally and internationally and determine which instructional tools, training methods, and curricula are consistent with what you have identified as best teaching methodologies and have led to or are likely to lead to a reduction in crashes. Further, incorporate these best practices into a model driver education and training curriculum; and (H-05-24) In cooperation with the National Highway Traffic Safety Administration, determine the optimum sequencing, in conjunction with graduated driver licensing qualifications, for educating teenagers on safe driving skills, both in the classroom and behind the wheel, and encourage the States to adopt this requirement. KW - Best practices KW - Curricula KW - Driver education KW - Driver training KW - Graduated licensing KW - Recommendations KW - Teenage drivers KW - Traffic safety KW - U.S. Department of Education KW - U.S. National Highway Traffic Safety Administration UR - https://trid.trb.org/view/763288 ER - TY - RPRT AN - 01007200 AU - National Transportation Safety Board TI - National Transportation Safety Board Public Forum on Driver Education and Training, October 28-29, 2003. Report of Proceedings PY - 2005/08/01 SP - 304p AB - The National Transportation Safety Board convened a 2-day public forum in October 2003 to survey the current state of novice driver education and training, including the extent to which it is used, its effectiveness and shortcomings, and what can be done to improve it. While driver education has been available since the 1930s and, intuitively, should improve driving safety, in fact little consensus exists on the benefits of driver education and training, what it should entail, and how it should be delivered. The 29 forum participants included the National Highway Traffic Safety Administration, State government representatives, safety and consumer associations, groups offering driver education, and teachers, students, and researchers. This document provides a report of proceedings of this public forum (Introduction; Driver Education Forum Summary, Conclusions, and Recommendations; Graduated Driver Licensing Recommendations; Novice Driver Requirements in the 50 States and District of Columbia) and includes the transcript of the public forum within Part 5. KW - Conferences KW - Driver education KW - Driver training KW - Graduated licensing KW - Recommendations KW - Regulations KW - State of the practice KW - States UR - https://trid.trb.org/view/763684 ER - TY - RPRT AN - 01006015 AU - National Transportation Safety Board TI - Report of Proceedings: National Transportation Safety Board Public Forum on Driver Education and Training October 28-29, 2003 PY - 2005/08/01 SP - 296p AB - The National Transportation Safety Board convened a 2-day public forum in October 2003 to survey the current state of novice driver education and training, including the extent to which it is used, its effectiveness and shortcomings, and what can be done to improve it. While driver education has been available since the 1930s and, intuitively, should improve driving safety, in fact little consensus exists on the benefits of driver education and training, what it should entail, and how it should be delivered. The 29 forum participants included the National Highway Traffic Safety Administration, State government representatives, safety and consumer associations, groups offering driver education, and teachers, students, and researchers. This document provides a report of proceedings of this public forum and includes the transcript of the public forum within Part 5. As a result of this report of proceedings, the Safety Board makes safety recommendations to the U.S. Department of Education and the National Highway Traffic Safety Administration. KW - Benefits KW - Driver education KW - Driver experience KW - Driver training KW - Drivers KW - Effectiveness KW - Highway safety KW - Novices KW - Recommendations KW - Safety programs KW - Shortcomings KW - Traffic safety KW - U.S. National Highway Traffic Safety Administration KW - U.S. National Transportation Safety Board KW - United States KW - Utilization UR - http://www.ntsb.gov/doclib/reports/2005/rp0501.pdf UR - https://trid.trb.org/view/761573 ER - TY - RPRT AN - 01014941 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding of the Alaska Marine Highway System Ferry LeConte Near Sitka, Alaska, May 10, 2004 PY - 2005/07/28 SP - 3p AB - The Alaska Marine Highway System ferry LeConte was en route from Angoon to Sitka, Alaska, when it ran aground on Cozian Reef, a well-marked navigation hazard about 30 miles north of Sitka, Alaska. The navigation watch was attempting to navigate an alternative route that was more scenic. The weather was good and visibility was clear. One passenger was injured, and the LeConte experienced extensive hull damage. The National Transportation Safety Board determines that the probable cause of the grounding of the LeConte was the failure of the master and the chief mate, who was conning the vessel, to recognize that the course selected by the chief mate would cause the vessel to pass on the wrong side of the navigation daymark for Cozian Reef and to pass over the reef. Contributing to the loss of awareness of the navigation situation was the fatigue of the conning officer, the chief mate, who had a significant sleep deficit because of work accomplished off watch in addition to standing a 6-hour watch routine. KW - Alaska KW - Crash causes KW - Fatigue (Physiological condition) KW - Ferries KW - Groundings (Maritime crashes) KW - Hazards KW - Hulls KW - Injuries KW - Loss and damage KW - Marine safety KW - Navigation KW - Route choice KW - Sleep deprivation UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0502.pdf UR - https://trid.trb.org/view/771501 ER - TY - RPRT AN - 01016496 AU - National Transportation Safety Board TI - Railroad Accident Report: Derailment of Amtrak Train No. 58, City of New Orleans, Near Flora, Mississippi, April 6, 2004 PY - 2005/07/26 SP - 62p AB - About 6:33 p.m. central daylight time on April 6, 2004, northbound National Railroad Passenger Corporation (Amtrak) train No. 58 (City of New Orleans), derailed on Canadian National Railway Company railroad track near Flora, Mississippi. The entire train, consisting of one locomotive, one baggage car, and eight passenger cars, derailed near milepost 196.5 while traveling about 78 mph. The train was carrying 61 passengers and 12 Amtrak employees. The derailment resulted in 1 fatality, 3 serious injuries, and 43 minor injuries. The equipment costs associated with the accident totaled about $7 million. As a result of its investigation of the accident, the Safety Board identified the following safety issues: the Canadian National Railway Company’s continuous welded rail maintenance and inspection procedures and standards, Amtrak’s emergency response training of its employees, and the Federal Railroad Administration’s oversight of continuous welded rail maintenance programs and Amtrak’s emergency response training of its employees. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Federal Railroad Administration, the Canadian National Railway Company, and Amtrak. KW - Amtrak KW - Canadian National Railways KW - Continuous welded rail KW - Costs KW - Derailments KW - Emergency response KW - Emergency training KW - Employees KW - Fatalities KW - Flora (Mississippi) KW - Injuries KW - Maintenance KW - Oversight KW - Procedures KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Standards KW - U.S. Federal Railroad Administration UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0502.pdf UR - https://trid.trb.org/view/771680 ER - TY - RPRT AN - 01007231 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-19 through -22 PY - 2005/07/21 SP - 8p AB - These safety recommendations, addressed to Mr. Michael W. Behrens, Executive Director, Texas Department of Transportation, concern the need to better identify areas with a high risk of accidents and implement the necessary roadway improvements. The National Transportation Safety Board makes the following recommendations to the Texas Department of Transportation: (H-05-19) Inventory highway locations where poor vertical geometries, combined with low coefficients of friction and speeds greater than the design speed of the roadway, may create a situation in which traffic has inadequate stopping sight distance, and develop and implement a plan for repaving or other roadway improvements; (H-05-20) Install variable speed limit signs or implement alternate countermeasures at locations where wet weather can produce stopping distances that exceed the available sight distance; (H-05-21) Change the Texas Pavement Management Information System to increase its emphasis on roadways with low coefficients of friction in determining maintenance priorities; and (H-05-22) Revise and validate the Texas Wet Weather Accident Reduction Program so that improvement priorities are not disproportionately influenced by the number of accidents that occur but also consider locations where surface conditions and roadway geometry lead to very low friction coefficients and dangerous conditions. KW - Coefficient of friction KW - Countermeasures KW - High risk locations KW - Improvements KW - Pavement management systems KW - Recommendations KW - Resurfacing KW - Speed limits KW - Stopping sight distance KW - Strategic planning KW - Texas Department of Transportation KW - Traffic safety KW - Variable message signs KW - Vertical alignment KW - Wet weather UR - https://trid.trb.org/view/763236 ER - TY - RPRT AN - 01007223 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-18 PY - 2005/07/21 SP - 5p AB - This safety recommendation, addressed to the Honorable Annette M. Sandberg, Administrator, Federal Motor Carrier Safety Administration (FMCSA), concerns the tread depth of commercial vehicle tires. The National Transportation Safety Board makes the following recommendation to the FMCSA: (H-05-18) Once the testing in recommendation H-05-17 is complete, modify the tread depth requirements for each axle to reflect the results of the research. KW - Commercial vehicles KW - Recommendations KW - Tires KW - Tread depth KW - U.S. Federal Motor Carrier Safety Administration UR - https://trid.trb.org/view/763234 ER - TY - RPRT AN - 01007209 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-17 PY - 2005/07/21 SP - 4p AB - This safety recommendation, addressed to the Honorable Jeffrey W. Runge, M.D., Administrator, National Highway Traffic Safety Administration (NHTSA), concerns tread depth of commercial vehicle tires. The National Transportation Safety Board makes the following recommendation to NHTSA: (H-05-17) Conduct testing on the effects of differing tread depths for the steer and drive axle tires. KW - Commercial vehicles KW - Recommendations KW - Tires KW - Tread depth KW - U.S. National Highway Traffic Safety Administration UR - https://trid.trb.org/view/763233 ER - TY - RPRT AN - 01007196 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-12 through -16 PY - 2005/07/21 SP - 8p AB - These safety recommendations, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration (FHWA), are concerned with Federal guidance on identifying and eliminating locations with wet weather accident problems. The National Transportation Safety Board makes the following recommendations to the FHWA: (H-05-12) Issue guidance to FHWA field offices describing the inadequate stopping sight distance that could occur when poor vertical geometries exist at locations with low coefficients of friction and speeds higher than the design speed and work with the States to inventory such locations; (H-05-13) Once the locations in recommendation H-05-12 have been identified, assist the States in developing and implementing a plan for repaving or other roadway improvements; (H-05-14) Issue guidance recommending the use of variable speed limit signs in wet weather at locations where the operating speed exceeds the design speed and the stopping distance exceeds the available sight distance; (H-05-15) Conduct research on commercial vehicle tire and wet pavement surface interaction to determine minimum frictional quality standards for commercial tires on wet pavement, and once completed (1) revise the tire requirements for commercial vehicles operating on wet pavement at highway speeds and (2) develop minimum acceptable pavement coefficients of friction and maximum permissible pavement rut depths as part of roadway maintenance requirements, as appropriate; and (H-05-16) Review State programs that identify and eliminate locations with a high risk of wet weather accidents and develop and issue a best practices guide on wet weather accident reduction. KW - Best practices KW - Coefficient of friction KW - Commercial vehicles KW - High risk locations KW - Recommendations KW - Resurfacing KW - Rut depth KW - Speed limits KW - Stopping sight distance KW - Tires KW - Traffic safety KW - Tread depth KW - U.S. Federal Highway Administration KW - Variable message signs KW - Vertical alignment KW - Wet weather UR - https://trid.trb.org/view/763230 ER - TY - RPRT AN - 01010899 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Median Crossover and Collision with Sport Utility Vehicle, Hewitt, Texas, February 14, 2003 PY - 2005/07/12 SP - 80p AB - On February 14, 2003, about 9:59 a.m., central standard time, a 1996 Dina Viaggio motorcoach, operated by Central Texas Trails, Inc., and occupied by a driver and 34 passengers, was traveling northbound on Interstate 35 near Hewitt, Texas. The weather was overcast with reduced visibility due to fog, haze, and heavy rain. As the motorcoach approached the crest of a hill, the bus driver said he observed brake lights ahead of him and began to brake lightly. The bus driver said that as he moved from the right lane into the left lane, another vehicle ahead of the bus also moved over, so he braked harder and the rear of the bus skidded. The bus driver was unable to maintain control of the bus as it departed the left side of the roadway, crossed the grassy median, entered the southbound lanes, and collided with a 2002 Chevrolet Suburban sport utility vehicle (Suburban) occupied by a driver and two passengers. The motorcoach then overturned on its right side, rotated, and slid to final rest facing south against a concrete embankment on the side of the road. The Suburban rotated 180 degrees, began to climb the embankment, slid back down, and came to rest facing north and against the roof of the bus. Five motorcoach passengers, the Suburban driver, and one Suburban passenger sustained fatal injuries. The bus driver sustained serious injuries; the remaining passengers on the bus and in the Suburban sustained injuries ranging from minor to serious. Major safety issues identified in this accident include: sight distance and speed as they relate to roadway design; roadway and tire friction interaction, particularly between commercial vehicle tires and wet pavement; the effect on vehicle stability of differing front and rear tire tread depths; and the need to better identify areas with a high risk of wet weather accidents and implement the necessary roadway improvements. As a result of this investigation, the National Transportation Safety Board makes recommendations to the Federal Highway Administration, the National Highway Traffic Safety Administration, the Federal Motor Carrier Safety Administration, and the Texas Department of Transportation. KW - Bus crashes KW - Buses KW - Chevrolet Suburban KW - Crashes KW - Crossover accidents KW - Fatalities KW - Fog KW - Haze KW - High risk locations KW - Highway design KW - Highway safety KW - Highway traffic KW - Injuries KW - Rain KW - Recommendations KW - Rolling contact KW - Sight distance KW - Speed KW - Sport utility vehicles KW - Stability (Mechanics) KW - Texas KW - Tire treads KW - Tires KW - Traffic crashes KW - Traffic safety KW - Visibility KW - Wet weather UR - http://app.ntsb.gov/doclib/reports/2005/HAR0502.pdf UR - https://trid.trb.org/view/767307 ER - TY - RPRT AN - 01014916 AU - National Transportation Safety Board TI - Marine Accident Report: Capsizing of U.S. Small Passenger Vessel Tai-Tooo, Tillamook Bay Inlet, Oregon, June 14, 2003 PY - 2005/06/28 SP - 76p AB - This report discusses the June 14, 2003 accident in which the U.S. small passenger vessel Taki-Tooo capsized while attempting to cross the bar at Tillamook Bay, Oregon. A master, deckhand, and 17 passengers were on board the charter fishing vessel when it was struck broadside by a wave and overturned. The master and 10 passengers died in the capsizing; the deckhand and 7 passengers sustained minor injuries. The Taki-Tooo, with a replacement value of $180,000, was a total loss. From its investigation of the accident, the Safety Board identified the following major safety issues: decision to cross the bar, Tillamook Bay operations, and survivability. On the basis of its findings, the Safety Board made recommendations to the U.S. Coast Guard, the National Marine Charter Association, and the owners and operators of charter fishing vessels operating out of Tillamook Bay, Oregon. KW - Capsizing KW - Fatalities KW - Injuries KW - Loss and damage KW - Marine safety KW - Operations KW - Oregon KW - Passenger ships KW - Recommendations KW - Survivability KW - Water transportation crashes KW - Waves UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0502.pdf UR - https://trid.trb.org/view/771505 ER - TY - RPRT AN - 01016516 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision, Derailment, Hazardous Materials Release, and Fire in Alton and Southern Railway Company Classification Hump Yard in East St. Louis, Illinois, September 21, 2004 PY - 2005/06/27 SP - 4p AB - On September 21, 2004, about 3:25 a.m., central daylight time, the Alton and Southern Railway Company remote control train YAS313 derailed during switching operations at the east end of the Gateway Hump Yard in East St. Louis, Illinois. The remote control operator was unable to control the speed of the train as it crested the hump. As the train entered track 066, it collided at 9.6 mph with a tank car containing vinyl acetate. During the collision and subsequent derailment, vinyl acetate began to leak from two tank cars and the cargo from both cars caught on fire. About 140 people from the surrounding neighborhood were evacuated, and work at the hump yard was suspended. The evacuation order was lifted about 6:00 a.m. No injuries were reported. The weather was clear, about 67° Fahrenheit, with light winds from the south-southeast. It was dark at the time of the accident, but the area was well lit with stadium type lighting. The National Transportation Safety Board determines that the probable cause of the September 21, 2004, accident at the Alton and Southern Railway Company's Gateway Hump Yard in East St. Louis, Illinois, was the inability of the remote control operator to control the speed of the cars being switched as they crested the hump because the weight of the cars exceeded the braking capability of the remote control locomotives. Contributing to the accident was the failure of the Alton and Southern Railway Company to have weight limits and adequate hump operation procedures in place for maneuvering heavy strings of cars over the hump. KW - Alton and Southern Railway Company KW - Braking KW - Classification yards KW - Crashes KW - Derailments KW - East Saint Louis (Illinois) KW - Fires KW - Gateway Hump Yard KW - Hazardous materials KW - Hump yards KW - Operations KW - Operators (Persons) KW - Procedures KW - Railroad cars KW - Railroad crashes KW - Railroad safety KW - Railroad trains KW - Remote control KW - Size and weight regulations KW - Speed KW - Tank cars KW - Vinyl acetate KW - Weight UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0504.pdf UR - https://trid.trb.org/view/771682 ER - TY - RPRT AN - 01014920 AU - National Transportation Safety Board TI - Highway Accident Brief: Collision Between Passenger Vehicle and Tractor-Semitrailer, Belgrade, Montana, January 23, 2003 PY - 2005/06/20 SP - 6p AB - About 3:20 p.m. on January 23, 2003, a 1997 Oldsmobile Achieva driver education vehicle was westbound on Amsterdam Road near Belgrade, Montana. A driver education student, age 14 years, 8 months, was driving; an instructor was in the right-front passenger seat, and two other students were seated in the rear seat. About the same time, a 1991 International Truck and Engine Corporation truck tractor with a 1998 Utility Trailer Manufacturing Company semitrailer was eastbound on Amsterdam Road. The weather was clear. Snow earlier in the day had resulted in an accumulation of slush on the roadway in places shaded by patches of trees. The truck driver estimated that his vehicle and the Oldsmobile were traveling 35 to 45 mph. He stated that he saw the oncoming automobile from a distance of more than 100 yards and noticed no indication of a problem. Just after the tractor-semitrailer crossed a short bridge over a ditch, the truck driver said the Oldsmobile began to fishtail and veered into the eastbound lane in front of the tractor-semitrailer. The tractor-semitrailer driver said that he tried to avoid the collision by steering left, but he struck the Oldsmobile on the right side, causing the Oldsmobile to rotate clockwise, strike the right side of the tractor, and then slide down an embankment on the south side of the roadway. The tractor came to rest facing north, blocking both lanes of traffic. All four of the Oldsmobile's occupants were killed. Inspections of the Oldsmobile and the tractor semitrailer did not reveal any anomalies in the braking or steering systems. The National Transportation Safety Board determines that the probable cause of this accident was the Oldsmobile driver's loss of control due to the slushy roadway conditions. Contributing to the loss of control was the driver's inexperience driving in degraded winter weather. KW - Automobiles KW - Driver education KW - Driver experience KW - Fatalities KW - Fishtailing KW - Highway safety KW - Loss of control KW - Montana KW - Slush KW - Students KW - Teenage drivers KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic safety KW - Truck drivers KW - Weather KW - Winter UR - http://app.ntsb.gov/doclib/reports/2005/HAB0502.pdf UR - https://trid.trb.org/view/771497 ER - TY - RPRT AN - 01016466 AU - National Transportation Safety Board TI - Railroad Accident Brief: Side Collision of Burlington Northern Santa Fe Railway Train and Union Pacific Railroad Train near Kelso, Washington, November 15, 2003 PY - 2005/06/06 SP - 8p AB - About 7:40 a.m. on Saturday, November 15, 2003, Union Pacific Railroad (UP) northbound train UGLSE-14, consisting of 3 locomotives and 90 empty cars, struck southbound Burlington Northern Santa Fe Railway Company (BNSF) train UINBR001-14, consisting of 3 locomotives and 32 loaded cars. The BNSF train was struck about seven container platforms behind the locomotives, resulting in five derailed cars. The striking UP train had all 3 locomotives and 15 of its cars derail as a result of the collision. Both members of the UP crew were seriously injured. The two BNSF crewmembers did not sustain any injuries. The railroad in the area of the accident is owned by BNSF and is used jointly by BNSF and UP. The accident occurred at milepost (MP) 102.7 at the interlocking of Longview Junction South, near Kelso, Washington. About 2,800 gallons of fuel were released from the ruptured fuel tanks of the UP locomotives. A nearby train crew extinguished a minor fire. Weather conditions were overcast with light rain and a temperature of 44° Fahrenheit. Estimated damages were $2.7 million. The National Transportation Safety Board determines that the probable cause of the November 15, 2003, Union Pacific Railroad collision with a Burlington Northern Santa Fe Railway Company train near Kelso, Washington, was the Union Pacific Railroad crewmembers' neglect of the information conveyed by the wayside signal system because they were asleep. The engineer's and conductor's respective health conditions in combination with irregular work schedules contributed to the accident. The lack of a positive train control system was also a contributing factor. KW - BNSF Railway KW - Conductors (Trains) KW - Crash causes KW - Derailments KW - Fires KW - Fuel tanks KW - Fuels KW - Health KW - Hours of labor KW - Injuries KW - Kelso (Washington) KW - Locomotive engineers KW - Locomotives KW - Positive train control KW - Railroad crashes KW - Railroad safety KW - Railroad trains KW - Rupture KW - Side crashes KW - Sleep KW - Union Pacific Railroad KW - Wayside signals UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0503.pdf UR - https://trid.trb.org/view/771683 ER - TY - RPRT AN - 01016492 AU - National Transportation Safety Board TI - Railroad Accident Brief: Derailment of Union Pacific (UP) Freight Train ZLAMN-16 Near Pico Rivera, California, October 16, 2004 PY - 2005/05/31 SP - 9p AB - About 9:40 a.m., on October 16, 2004, eastbound Union Pacific Railroad (UP) freight train ZLAMN-16 derailed 3 locomotives and 11 cars near Pico Rivera, California. Some of the derailed cars struck nearby residences. Small amounts of hazardous materials were released from transported cargo. An estimated 5,000 gallons of diesel fuel were released from the locomotive fuel tanks when they ruptured during the derailment. About 100 people were evacuated from the area. There were no injuries to area residents, the train crew, or emergency response personnel. At the time of the derailment, the sky was overcast. The wind was from the south at approximately 6 mph. The temperature was 66° F. The UP estimated the monetary damage at $2.7 million. The National Transportation Safety Board determines that the probable cause of the derailment was the failure of a pair of insulated joint bars due to fatigue cracking. Contributing to the accident was the lack of an adequate on-the-ground inspection program for identifying cracks in rail joint bars before they grow to critical size. KW - Cracking KW - Crash causes KW - Derailments KW - Diesel fuels KW - Dwellings KW - Evacuation KW - Failure KW - Fatigue (Mechanics) KW - Freight trains KW - Hazardous materials KW - Inspection KW - Locomotives KW - Loss and damage KW - Rail joint bars KW - Rail joints KW - Railroad cars KW - Railroad crashes KW - Railroad safety KW - Rupture KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0502.pdf UR - https://trid.trb.org/view/771715 ER - TY - RPRT AN - 01014928 AU - National Transportation Safety Board TI - Aircraft Accident Report: Hard Landing, Gear Collapse, Federal Express Flight 647, Boeing MD-10-10F, N364FE, Memphis, Tennessee, December 18, 2003 PY - 2005/05/17 SP - 120p AB - This report explains the accident involving Federal Express flight 647, a Boeing MD-10-10F, N364FE, which crashed while landing at Memphis International Airport (MEM), Memphis, Tennessee. Safety issues in this report focus on flight crew performance, emergency evacuations, MEM air traffic control and aircraft rescue and fire fighting issues, and flight data recorder reliability. KW - Air traffic control KW - Air transportation crashes KW - Aviation safety KW - Boeing aircraft KW - Collapse KW - Crash landing KW - Emergencies KW - Evacuation KW - FedEx Corporation KW - Fire fighting KW - Flight crews KW - Flight recorders KW - Hard landings KW - Landing gear KW - Memphis International Airport KW - Performance KW - Rescue equipment UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0501.pdf UR - https://trid.trb.org/view/771553 ER - TY - RPRT AN - 01014925 AU - National Transportation Safety Board TI - Safety Report: Current Procedures for Collecting and Reporting U.S. General Aviation Accident and Activity Data PY - 2005/04/29 SP - 38p AB - Unlike Part 121 and scheduled Part 135 air carriers, general aviation operators and on-demand Part 135 operators (air taxis) are not required to report actual flight activity data to DOT. Instead, the Federal Aviation Administration (FAA) uses its annual General Aviation and Air Taxi Activity (GAATA) Survey to query a sample of registered aircraft owners, either through the Internet or by mail. The National Transportation Safety Board and others rely on GAATA Survey activity estimates to calculate accident rates and statistics that form the basis for assessing general aviation safety in the United States. Congress, government agencies, the aviation industry, and other researchers frequently cite accident rates when evaluating the need for safety initiatives. Valid activity data are necessary to compare the accident rates for different aircraft types and types of operations, to establish baseline measures that can be used to identify and track accident trends, and to assess the effectiveness of safety improvement efforts. Because of a critical need for accurate activity measures, and the perception of possible problems with current general aviation activity estimates, the Safety Board analyzed several general aviation exposure measures to determine the relationship of trends over time. The results of that analysis are included in this report. One existing recommendation to the FAA is superseded in this report, two new recommendations are issued, and two existing recommendations are reiterated. KW - Air transportation crashes KW - Aviation safety KW - Crash rates KW - Data collection KW - Estimates KW - General aviation KW - General aviation aircraft KW - General aviation airports KW - General Aviation and Air Taxi Activity Survey KW - Procedures KW - Recommendations KW - Reporting KW - Trend (Statistics) KW - United States UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR0502.pdf UR - https://trid.trb.org/view/768075 ER - TY - RPRT AN - 01000743 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-09 PY - 2005/04/27 SP - 3p AB - This safety recommendation, addressed to Mr. Stephen F. Campbell, Executive Director, Commercial Vehicle Safety Alliance, addresses the identification and appropriate use of speed-restricted tires on motorcoaches. The National Transportation Safety Board recommends that the Commercial Vehicle Safety Alliance revise the "North American Standard Out-of-Service Criteria" to provide guidance on inspecting and examining tires to ensure that they have the proper speed rating for a vehicle's intended use. KW - Buses KW - Commercial Vehicle Safety Alliance KW - Guidelines KW - Inspection KW - Recommendations KW - Tires UR - https://trid.trb.org/view/756514 ER - TY - RPRT AN - 01000768 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-02 through -05 PY - 2005/04/27 SP - 7p AB - These safety recommendations, addressed to the Honorable Annette M. Sandberg, Administrator, Federal Motor Carrier Safety Administration, address issues involved in the safe operation of motorcoaches. The National Transportation Safety Board makes the following safety recommendations to the Federal Motor Carrier Safety Administration: (H-05-02) Develop and distribute educational materials for nontraditional commercial vehicle owners, such as church groups, on how to comply with the Federal Motor Carrier Safety Regulations and, at a minimum, post the materials on the Federal Motor Carrier Safety Administration Web site; (H-05-03) Revise the Federal Motor Carrier Safety Regulations appendix G to subchapter B, "Minimum Periodic Inspection Standards," Part 10: "Tires," Section A(5) and B(7), to include inspection criteria and specific language to address a tire's speed rating to ensure that it is appropriate for a vehicle's intended use; (H-05-04) Conduct a study on the safety effectiveness of the self-inspection and certification process used by motor carriers to comply with annual vehicle inspection requirements and take corrective action, as necessary; and (H-05-05) Develop a method for inspecting motorcoach passenger seat mounting anchorages and revise the Federal Motor Carrier Safety Regulations appendix G to subchapter B, "Minimum Periodic Inspection Standards," to require inspection of these anchorages. KW - Anchorages KW - Buses KW - Certification KW - Compliance KW - Education KW - Inspection KW - Motor carriers KW - Owner operators KW - Recommendations KW - Regulations KW - Seats KW - Tires KW - U.S. Federal Motor Carrier Safety Administration KW - Vehicle safety UR - https://trid.trb.org/view/756505 ER - TY - RPRT AN - 01000765 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-06 through -08 PY - 2005/04/27 SP - 5p AB - These safety recommendations, addressed to Ms. Linda Lewis-Pickett, President and Chief Executive Officer, American Association of Motor Vehicle Administrators, address the adequacy of State and Federal oversight of motor carriers, the identification and appropriate use of speed-restricted tires on motorcoaches, and the criteria for State and Federal annual inspections of motorcoach passenger seating anchorage points. The National Transportation Safety Board makes the following recommendations to the American Association of Motor Vehicle Administrators: (H-05-06) Develop, and disseminate to the States, model language for title and registration applications to alert applicants to the Federal definition of a commercial vehicle and to the need to contact the Federal Motor Carrier Safety Administration for guidance on obtaining a U.S. Department of Transportation number and on determining the applicability of Federal safety regulations to their vehicle; (H-05-07) Revise your "Vehicle Inspection Handbook: Trucks, Buses, and Trailers" to provide guidance on inspecting and examining tires to ensure that they have the proper speed rating for a vehicle's intended use; (H-05-08) Develop a method for inspecting motorcoach passenger seat mounting anchorages and revise your "Vehicle Inspection Handbook: Trucks, Buses, and Trailers" to include the inspection procedures. KW - American Association of Motor Vehicle Administrators KW - Anchorages KW - Buses KW - Guidelines KW - Handbooks KW - Inspection KW - Motor carriers KW - Oversight KW - Recommendations KW - Registration KW - Regulations KW - Seats KW - Tires UR - https://trid.trb.org/view/756513 ER - TY - RPRT AN - 01000762 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-10 and -11 PY - 2005/04/27 SP - 5p AB - These safety recommendations, addressed to Mr. John Russell, Chief Executive Officer, Neoplan USA Corporation, address inspections of motorcoach passenger seating anchorage points and performance standards for motorcoach passenger seating anchorages. The National Transportation Safety Board makes the following safety recommendations to Neoplan USA Corporation: (H-05-10) Include information in your motorcoach owner's and maintenance manuals that fully informs owners of the necessity of, and proper procedures for, checking passenger seat anchorage securement through routine inspections; and (H-05-11) Until the National Highway Traffic Safety Administration develops performance standards for passenger seat anchorages in motorcoaches, substantially increase the load capacity of the passenger seat anchor systems in your newly manufactured motorcoaches so that the seats will not become detached during frontal impact collisions, side impact collisions, rear impact collisions, and rollovers. KW - Anchorages KW - Bearing capacity KW - Buses KW - Crashes KW - Inspection KW - Manuals KW - Neoplan USA Corporation KW - Performance KW - Recommendations KW - Seats KW - Standards UR - https://trid.trb.org/view/756517 ER - TY - RPRT AN - 01000750 AU - Rosenker, Mark V AU - National Transportation Safety Board TI - National Transportation Safety Board Safety Recommendation, H-05-01 PY - 2005/04/27 SP - 3p AB - This safety recommendation, addressed to the Honorable Jeffrey W. Runge, M.D., Administrator, National Highway Traffic Safety Administration, addresses the issue of performance standards for motorcoach passenger seating anchorages. The National Transportation Safety Board recommends that the National Highway Traffic Safety Administration develop performance standards for passenger seat anchorages in motorcoaches. KW - Anchorages KW - Buses KW - Performance KW - Recommendations KW - Seats KW - Standards KW - U.S. National Highway Traffic Safety Administration UR - https://trid.trb.org/view/756503 ER - TY - RPRT AN - 01001983 AU - National Transportation Safety Board TI - Highway Accident Report: Motorcoach Run-Off-The-Road Accident, Tallulah, Louisiana, October 13, 2003 PY - 2005/04/19 SP - 100p AB - At 10:50 a.m. on October 13, 2003, a 1992 Neoplan USA Corporation 49-passenger motorcoach, owned and operated by the First Baptist Church of Eldorado, Texas, was traveling eastbound on Interstate 20 near Tallulah, Louisiana. The motorcoach, carrying 14 passengers, was en route from Shreveport, Louisiana, to Tuscaloosa, Alabama, as part of a multicity sightseeing tour that had originated in Eldorado. As the motorcoach approached milepost 168, it drifted rightward from the travel lanes and onto the shoulder, where it struck the rear of a 1988 Peterbilt tractor semitrailer operated by Alpha Trucking, Inc., which was stopped on the shoulder at milepost 167.9. As both vehicles moved forward, the motorcoach rotated clockwise slightly and the semitrailer rotated counter-clockwise slightly; the vehicles remained together. They traveled approximately 62 feet and came to rest, still oriented to the east, adjacent to the right side of the interstate on the outside shoulder. Eight motorcoach passengers sustained fatal injuries, the motorcoach driver and six passengers received serious injuries, and the Peterbilt driver was not injured. Major safety issues identified in this report include driver fatigue, the adequacy of State and Federal oversight of motor carriers, the identification and appropriate use of speed-restricted tires on motorcoaches, criteria for State and Federal annual inspections of motorcoach passenger seating anchorage points, and performance standards for motorcoach passenger seating anchorages. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the National Highway Traffic Safety Administration, the Federal Motor Carrier Safety Administration, the American Association of Motor Vehicle Administrators, the Commercial Vehicle Safety Alliance, and Napoleon USA Corporation. KW - American Association of Motor Vehicle Administrators KW - Anchors (Structural connectors) KW - Bus drivers KW - Buses KW - Commercial Vehicle Safety Alliance KW - Crash causes KW - Fatalities KW - Fatigue (Physiological condition) KW - Federal government KW - Highway safety KW - Injuries KW - Inspection KW - Louisiana KW - Neoplan USA Corporation KW - Oversight KW - Passengers KW - Performance KW - Ran off road crashes KW - Recommendations KW - Road shoulders KW - Seats KW - Speed restricted tires KW - Standards KW - State government KW - Texas KW - Tourists KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic lanes KW - Traffic safety KW - U.S. Federal Motor Carrier Safety Administration KW - U.S. National Highway Traffic Safety Administration UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0501.pdf UR - https://trid.trb.org/view/757506 ER - TY - RPRT AN - 01016505 AU - National Transportation Safety Board TI - Railroad Accident Brief: Collision of Runaway Locomotive on Long Island Rail Road in Queens, New York, on March 10, 2004 PY - 2005/04/18 SP - 10p AB - On March 10, 2004, about 2:18 p.m., the crew of a Long Island Rail Road (LIRR) train, assigned to reposition equipment in various locations, left a locomotive (LIRR 160) unattended with only its air brakes applied. The locomotive was left on a descending grade in the Fresh Pond yard of the New York & Atlantic Railway (NYAR) in Queens, New York. The locomotive rolled away and traveled through the yard and onto the Bushwick Branch of the NYAR, where it passed over seven passive grade crossings and struck numerous vehicles before coming to a stop. Four occupants of three struck vehicles were seriously injured. A fire occurred when the locomotive came to a stop, after its collision with the last two vehicles. The LIRR estimated equipment damages of $83,000; the NYAR estimated minimal damages. The National Transportation Safety Board determines that the probable cause of the multiple highway/railroad grade crossing collisions in Queens, New York, on March 10, 2004, was the failure of the Long Island Rail Road conductor and assistant conductor/brakeman to secure the locomotive when they left it unattended on a descending grade. KW - Air brakes KW - Conductors (Trains) KW - Crash causes KW - Descending grade KW - Fires KW - Injuries KW - Long Island Rail Road KW - Loss and damage KW - Motor vehicles KW - Queens (New York, New York) KW - Railroad crashes KW - Railroad grade crossings KW - Railroad safety KW - Railroad yards KW - Runaway locomotives KW - Train/motor vehicle collisions UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0501.pdf UR - https://trid.trb.org/view/771716 ER - TY - RPRT AN - 01003117 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of Staten Island Ferry Andrew J. Barberi, St. George, Staten Island, New York, October 15, 2003 PY - 2005/03/08 SP - 164p AB - About 3:20 p.m. on October 15, 2003, the Staten Island Ferry Andrew J. Barberi, owned and operated by the New York City Department of Transportation, was near the end of a regularly scheduled trip from Manhattan to Staten Island when it allided with a maintenance pier at the Staten Island Ferry terminal. Fifteen crewmembers and an estimated 1,500 passengers were on board. Ten passengers died in the accident and 70 were injured. An eleventh passenger died 2 months later as a result of injuries sustained in the accident. Hundreds of emergency personnel and dozens of emergency vehicles, including several vessels, responded to the accident, dispatched by the New York City Police Department, the New York City Fire Department (including emergency medical services), the U.S. Coast Guard, and the U.S. Army Corps of Engineers. Damages totaled more than $8 million, with repair costs of $6.9 million for the Andrew J. Barberi and $1.4 million for the pier. The National Transportation Safety Board determines that the probable cause of this accident was the assistant captain’s unexplained incapacitation and the failure of the New York City Department of Transportation to implement and oversee safe, effective operating procedures for its ferries. Contributing to the cause of the accident was the failure of the captain to exercise his command responsibility over the vessel by ensuring the safety of its operations. The Safety Board’s investigation of this accident identified safety issues in the following areas: actions of assistant captain and captain; New York City Department of Transportation oversight of ferry operations; medical oversight of mariners; safety management systems; and potential contribution of navigation technology to the safety of ferry operations. As a result of its investigation, the Safety Board makes recommendations to the New York City Department of Transportation, the U.S. Coast Guard, the States that operate public ferries, and the Passenger Vessel Association. KW - Allisions KW - Fatalities KW - Ferries KW - Injuries KW - Maritime safety KW - New York (New York) KW - New York City Department of Transportation KW - Operating rules KW - Oversight KW - Passenger Vessel Association KW - Recommendations KW - Safety management KW - Ship pilotage KW - Ship pilots KW - State government KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0501.pdf UR - https://trid.trb.org/view/759251 ER - TY - RPRT AN - 01014938 AU - National Transportation Safety Board TI - Highway Accident Brief: Multiple-Vehicle Collision and Fire on Interstate Highway 40, Cuervo, New Mexico, March 8, 2002 PY - 2005/03/07 SP - 4p AB - On March 8, 2002, about 1:18 p.m., a Union Pacific Railroad (UP) work crew was replacing rail near the town of Cuervo, New Mexico. Open-flame track-mounted torches were being used to heat the new rail before attaching it to crossties. As the work crew proceeded eastbound on the track, a smoldering railroad crosstie ignited a large, fast-moving brush fire. High winds drove the fire and smoke in a southeasterly direction toward Interstate 40 (I-40). The smoke eventually blew across the highway, reducing visibility in all four lanes. Twelve vehicles on the roadway collided, resulting in 7 fatalities, 3 serious injuries, and 13 minor injuries. The vehicles involved in the collision include 3 tractor-semitrailers, 2 trucks, 1 pickup truck, 4 passenger vehicles, 1 school bus and 1 motor home. The National Transportation Safety Board determines that the probable cause of this accident was the work crew foreman’s failure to consider the effects of high winds on the open-flame rail replacement activity. Contributing to the accident was the lack of specific guidance for the work crew on the fire hazards of welding, grinding, or cutting operations. The failure of the motorists to slow their vehicles sufficiently as they entered the area of reduced visibility contributed to the severity of the accident. KW - Brush KW - Construction and maintenance personnel KW - Crossties KW - Cutting KW - Fatalities KW - Fire KW - Flames KW - Grinding KW - Hazards KW - Highway safety KW - Injuries KW - Interstate highways KW - Maintenance of way KW - Multiple vehicle crashes KW - New Mexico KW - Passenger vehicles KW - Pickup trucks KW - Rail (Railroads) KW - Recreational vehicles KW - School buses KW - Smoke KW - Speed KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic safety KW - Trucks KW - Visibility KW - Welding KW - Wind UR - http://app.ntsb.gov/doclib/reports/2005/HAB0501.pdf UR - https://trid.trb.org/view/771498 ER - TY - RPRT AN - 01016491 AU - National Transportation Safety Board TI - Railroad Accident Report: Derailment of Canadian National Freight Train M33371 and Subsequent Release of Hazardous Materials in Tamaroa, Illinois, February 9, 2003 PY - 2005/01/25 SP - 42p AB - About 9:04 a.m. central standard time on February 9, 2003, northbound Canadian National freight train M33371 derailed 22 of its 108 cars in Tamaroa, Illinois. Four of the derailed cars released methanol, and the methanol from two of these four cars fueled a fire. Other derailed cars contained phosphoric acid, hydrochloric acid, formaldehyde, and vinyl chloride. Two cars containing hydrochloric acid, one car containing formaldehyde, and one car containing vinyl chloride released product but were not involved in the fire. About 850 residents were evacuated from the area within a 3-mile radius of the derailment, which included the entire village of Tamaroa. No one was injured during the derailment, although one contract employee was injured during cleanup activities. Damages to track, signals, and equipment, and clearing costs associated with the accident totaled about $1.9 million. The safety issues addressed in the report are the effect of bond wire welding on rail integrity and inconsistent instructions regarding the exothermic welding of bond wires. As a result of its investigation of this accident, the Safety Board makes recommendations to the Federal Railroad Administration; ERICO Products, Inc.; and the American Railway Engineering and Maintenance-of-Way Association. KW - Bond wire welding KW - Canadian National KW - Costs KW - Derailments KW - Equipment KW - Evacuation KW - Exothermic welding KW - Fires KW - Formaldehyde KW - Freight trains KW - Hazardous materials KW - Hydrochloric acid KW - Injuries KW - Instructions KW - Integrity KW - Loss and damage KW - Methanol KW - Phosphoric acid KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety KW - Railroad signals KW - Railroad tracks KW - Recommendations KW - Tamaroa (Illinois) KW - Vinyl chloride UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0501.pdf UR - https://trid.trb.org/view/771717 ER - TY - RPRT AN - 01001988 AU - National Transportation Safety Board TI - Highway Accident Brief: Vehicle Loss of Control, Followed by Sideswipe Collisions with Tractor-Semitrailer PY - 2005 SP - 6p AB - About 3:20 p.m. on January 23, 2003, a 1997 Oldsmobile Achieva driver education vehicle was westbound on Amsterdam Road near Belgrade, Montana. A driver education student, age 14 years, 8 months, was driving; an instructor was in the right-front passenger seat, and two other students were seated in the rear seat. About the same time, a 1991 International Truck and Engine Corporation truck tractor with a 1998 Utility Trailer Manufacturing Company semitrailer was eastbound on Amsterdam Road. The weather was clear. Snow earlier in the day had resulted in an accumulation of slush on the roadway in places shaded by patches of trees. The truck driver estimated that his vehicle and the Oldsmobile were traveling 35 to 45 mph. He stated that he saw the oncoming automobile from a distance of more than 100 yards and noticed no indication of a problem. Just after the tractor-semitrailer crossed a short bridge over a ditch, the truck driver said the Oldsmobile began to fishtail and veered into the eastbound lane in front of the tractor-semitrailer. The tractor-semitrailer driver said that he tried to avoid the collision by steering left, but he struck the Oldsmobile on the right side, causing the Oldsmobile to rotate clockwise, strike the right side of the tractor, and then slide down an embankment on the south side of the roadway. The tractor came to rest facing north, blocking both lanes of traffic. All 4 of the Oldsmobile occupants were killed. Inspections of the Oldsmobile and the tractor semitrailer did not reveal any anomalies in the braking or steering systems. The National Transportation Safety Board determines that the probable cause of this accident was the Oldsmobile driver's loss of control due to the slushy roadway conditions. Contributing to the loss of control was the driver's inexperience driving in degraded winter weather. KW - Automobiles KW - Crash causes KW - Driver education KW - Driver experience KW - Fatalities KW - Fishtailing KW - Highway safety KW - Loss of control KW - Side crashes KW - Slush KW - Students KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic safety KW - Truck drivers KW - Weather conditions KW - Winter UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0502.pdf UR - https://trid.trb.org/view/757503 ER - TY - RPRT AN - 01001989 AU - National Transportation Safety Board TI - Highway Accident Brief: Multiple-Vehicle Collision and Fire PY - 2005 SP - 4p AB - On March 8, 2002, about 1:18 p.m., a Union Pacific Railroad (UP) work crew was replacing rail near the town of Cuervo, New Mexico. Open-flame track-mounted torches were being used to heat the new rail before attaching it to crossties. As the work crew proceeded eastbound on the track, a smoldering railroad crosstie ignited a large, fast-moving brush fire. High winds drove the fire and smoke in a southeasterly direction toward Interstate 40 (I-40). The smoke eventually blew across the highway, reducing visibility in all four lanes. Twelve vehicles on the roadway collided, resulting in 7 fatalities, 3 serious injuries, and 13 minor injuries. I-40 is a four-lane rural principal arterial highway, which runs parallel to the rail track and is located 7/10 mile to the south. An 80-foot-wide grassy median separates the two eastbound and two westbound lanes of I-40; the posted speed limit is 75 mph. According to witnesses and drivers on I-40, the density of the smoke varied along the highway. An eastbound 1999 Jeep sport utility vehicle and a 1989 U-haul straight truck towing a passenger car drove into the smoke near milepost (MP) 290.7, where—according to one driver—both vehicles slowed because of reduced visibility. A 1999 Kenworth truck tractor-semitrailer, owned by Kurtz Trucking Ltd. (Kurtz), and traveling behind the slower moving U-haul truck and Jeep, entered the area of thickened smoke and collided with both vehicles. The Kurtz truck then stopped in the right lane, partially blocking the left lane. The ensuing fire engulfed all three vehicles. The National Transportation Safety Board determines that the probable cause of this accident was the work crew foreman’s failure to consider the effects of high winds on the open-flame rail replacement activity. Contributing to the accident was the lack of specific guidance for the work crew on the fire hazards of welding, grinding, or cutting operations. The failure of the motorists to slow their vehicles sufficiently as they entered the area of reduced visibility contributed to the severity of the accident. KW - Arterial highways KW - Automobiles KW - Brush KW - Construction and maintenance personnel KW - Crash causes KW - Cuervo (New Mexico) KW - Cutting KW - Fatalities KW - Fire KW - Flames KW - Grinding KW - Hazards KW - Highway safety KW - Injuries KW - Interstate highways KW - Multiple vehicle crashes KW - Rail (Railroads) KW - Railroad ties KW - Railroad tracks KW - Rural highways KW - Smoke KW - Speed KW - Sport utility vehicles KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic safety KW - Visibility KW - Welding KW - Wind UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0501.pdf UR - https://trid.trb.org/view/757508 ER - TY - JOUR AN - 01000257 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Sedor, Joseph M TI - Air Cargo Safety Forum PY - 2005 VL - 1 IS - 1 SP - pp 45-48 AB - On March 30-31, 2004, the National Transportation Safety Board hosted the Air Cargo Safety Forum to spur industry stakeholders to address relevant safety issues in an effort to prevent the air cargo accident rate from increasing. The forum brought together more than 160 representatives from cargo and airline operators, government agencies and pilot associations to discuss air cargo safety and to share ideas that would help advance the important work currently being done in this area. This article briefly summarizes the proceedings. Sixteen papers from government and industry experts addressed the current state of the cargo industry, operational issues, human factors and regulatory issues. KW - Air cargo KW - Air pilots KW - Air transportation crashes KW - Airlines KW - Associations KW - Aviation safety KW - Cargo aircraft KW - Freight transportation KW - Government agencies KW - Human factors KW - Meetings KW - Operations KW - Regulations KW - State of the industry KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751200 ER - TY - JOUR AN - 01000264 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Bishop, Jennifer AU - Quinlan, Kevin AU - Roeber, Danielle AU - Van Etten, Gary TI - Driver Education and Training Forum PY - 2005 VL - 1 IS - 1 SP - pp 37-44 AB - On October 28-29, 2003, the National Transportation Safety Board (NTSB) hosted a public forum on driver education and training. The purpose of the forum was to survey the current state of novice driver education and training, the extent to which it is used, and its quality and effectiveness. The forum also explored the shortcomings in driver education and training and what can be done to improve it. Thirty experts from around the world provided their opinions, which will help the NTSB form recommendations to improve driver education and training aimed at reducing the number of teenage fatalities on the roads. This article describes the evolution of driver education and training as well as current graduated driver licensing programs. Programs initiated by various countries, states and companies to develop and support driver education are also discussed. KW - Driver education KW - Driver training KW - Graduated licensing KW - Novices KW - Programming (Planning) KW - Public information programs KW - Teenage drivers KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751199 ER - TY - JOUR AN - 01000260 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Zakar, Frank TI - Impact Resistance of Steel from Derailed Tank Cars in Minot, North Dakota PY - 2005 VL - 1 IS - 1 SP - pp 29-36 AB - On a freezing morning in January 2002, a freight train derailed in Minot, North Dakota, causing five tank cars that carried anhydrous ammonia to catastrophically rupture. The event led to immediate release of over 142,000 gallons of anhydrous ammonia, posing a great hazard to the local community. Charpy V-notch impact testing of samples removed from the shell portions of several catastrophically ruptured tank cars showed that the impact resistance of the steel for each tank car varied greatly. The National Transportation Safety Board (NTSB) metallurgical investigation also determined that brittle fractures and low impact resistance of the steel contributed to the catastrophic fracture of the tank cars. The paper discusses the results of Charpy V-notch impact testing of selected samples from the catastrophically fractured tanks cars and addresses options for improving the construction of future tank cars. The NTSB has recommended that the Federal Railroad Administration develop and implement tank car design-specific fracture toughness standards for steels and other construction materials for pressure tank cars used for the transportation of DOT Class 2 hazardous materials, including those in low-temperature service. KW - Anhydrous ammonia KW - Brittleness KW - Charpy V-notch impact test KW - Crash investigation KW - Derailments KW - Design standards KW - Fracture mechanics KW - Hazardous materials KW - Impact resistance KW - Impact tests KW - Low temperature KW - Minot (North Dakota) KW - Steel KW - Tank cars KW - Toughness KW - U.S. Federal Railroad Administration KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751197 ER - TY - JOUR AN - 01000253 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Schulze, Dana AU - Price, Jana AU - Panontin, Tina TI - Information Management in Aviation Accident Investigations PY - 2005 VL - 1 IS - 1 SP - pp 23-28 AB - National Transportation Safety Board (NTSB) staff members are evaluating two new investigation approaches designed to address interacting system elements and to document the evidence-gathering process. The first approach employs accident fault trees, qualitative models depicting the events, conditions and/or actions that are considered during an investigation as being potential contributors to the accident. The fault tree process is being used and evaluated in multiple ongoing NTSB aviation accident investigations. The second approach focuses on a Web-based tool, Investigation Organizer, which was developed by the National Aeronautics and Space Administration (NASA), Ames Research Center. Investigation Organizer was developed to facilitate the mishap investigation process for geographically dispersed teams by combining capabilities for storing, managing and organizing information. NTSB staff members were initially exposed to Investigation Organizer while assisting NASA during the Columbia accident investigation and are currently evaluating the tool for its potential to support NTSB accident investigations. KW - Air transportation crashes KW - Crash causes KW - Crash investigation KW - Evidence KW - Fault tree analysis KW - Information management KW - Information organization KW - Information storage and retrieval systems KW - Internet KW - U.S. National Aeronautics and Space Administration KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751195 ER - TY - JOUR AN - 01000261 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Kolly, Joseph M AU - Blanchet, Thierry TI - Applying Research Methods to Accident Investigations PY - 2005 VL - 1 IS - 1 SP - pp 14-22 AB - The National Transportation Safety Board (NTSB) uses both traditional investigation techniques and an alternate research method approach in its technical accident investigations to determine the failure process of systems. A traditional investigation may be employed if the complete failure process can be identified with sufficient accuracy primarily through observation and examination of evidence and through full-scale demonstrations. The alternate approach uses research, testing and analysis targeted to specific areas of insufficient or inadequate information. This approach is developed when the examination of evidence does not provide a complete understanding of the failure process, and full-scale demonstration tests are either impractical or unlikely to yield the necessary information. The amount and quality of available evidence, the existing knowledge base and uncertainties about the factors that may have affected the failure process may influence the determination that an alternate approach using various research methods is necessary. This paper discusses the NTSB's successful use of research methods to investigate the failure of the jackscrew assembly in the Alaska Airlines Flight 261 accident. KW - Air transportation crashes KW - Alaska Airlines KW - Case studies KW - Crash causes KW - Crash investigation KW - Evidence KW - Failure analysis KW - Research KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751194 ER - TY - JOUR AN - 01000255 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Oberstar, James L TI - Fighting Fatigue PY - 2005 VL - 1 IS - 1 SP - pp 11-13 AB - Operator fatigue is a serious issue in transportation, and one that cuts across all transportation modes. The National Transportation Safety Board (NTSB) has been a leader in the effort to mitigate the impact of fatigue on pilots, truck drivers and motorists, and to reduce fatigue-related accidents, injuries and fatalities. However, the regulatory agencies responsible for making and enforcing the rules for these transportation modes have not always been as responsive. This article discusses how the Federal Aviation Administration and the Federal Motor Carrier Safety Administration could better address the issue of fatigue. One step in the right direction is a course offered at the NTSB's training academy that specifically investigates human fatigue factors in transportation accidents. KW - Air pilots KW - Aviation safety KW - Drivers KW - Fatigue (Physiological condition) KW - Federal government agencies KW - Highway safety KW - Human factors in crashes KW - Occupational safety KW - Operators (Persons) KW - Regulatory reform KW - Safety education KW - Transportation safety KW - U.S. Federal Aviation Administration KW - U.S. Federal Motor Carrier Safety Administration KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751180 ER - TY - JOUR AN - 01000263 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - YOUNG, DON TI - Safety and Security Vital to America's Transportation System PY - 2005 VL - 1 IS - 1 SP - pp 8-9 AB - This paper describes how the Transportation and Infrastructure Committee of the House of Representatives is working to ensure transportation safety and security, especially in the aviation field. The Committee has passed legislation that requires the Secretary of Transportation to submit an annual report to Congress and to the National Transportation Safety Board (NTSB) on the status of each recommendation on the NTSB's "most wanted" list of safety improvements. To improve transportation security, the Committee has conducted approximately 50 public hearings, held multiple classified meetings and briefings, worked with the Administration to make regulatory security improvements, and worked with the 9/11 Commission to implement expanded security programs. Several pieces of legislation have been authored by this Committee to address the security issues raised in these hearings and meetings. Although this article primarily concerns legislation addressing aviation safety and security, legislation designed to improve maritime, pipeline and railroad safety and security is also summarized. KW - Air transportation KW - Air transportation policy KW - Congressional hearings KW - Legislation KW - Maritime safety KW - Meetings KW - Pipeline safety KW - Railroad safety KW - Security KW - Transportation safety KW - U.S. House of Representatives KW - U.S. National Transportation Safety Board UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751179 ER - TY - JOUR AN - 01000259 JO - Journal of Accident Investigation PB - National Transportation Safety Board AU - Molinari, Susan TI - Combating Hardcore Drunk Driving. Innovative Funding Sources and Courtroom Strategies PY - 2005 VL - 1 IS - 1 SP - pp 5-7 AB - Hardcore drunk drivers are individuals who drive with a blood alcohol concentration of .15 or above, who have more than one drunk driving arrest, and who are highly resistant to changing their behavior despite previous education efforts, treatment or sanctions. This article describes efforts by The Century Council to develop strategies and tactics to more effectively address hardcore drunk drivers. The Council has worked with other members of the traffic safety community to implement programs and enact effective state laws to address hardcore drunk driving. They have developed a sourcebook that includes information on a broad range of policies, laws, sanctions and treatment programs. Since the judicial system plays a critical role in reducing hardcore drunk driving, the Council also has developed a guide aimed at the judiciary that outlines the issue of hardcore drunk driving, effective strategies and model programs. The Council is also encouraging states to adopt self-sustaining, offender-funded systems to fund local drunk driving prevention programs. KW - Century Council KW - Drunk drivers KW - Drunk driving KW - Financing KW - Guides to information KW - Judges KW - Jurisprudence and judicial processes KW - Legislation KW - Partnerships KW - Recidivists KW - Repeat offenders KW - Safety programs UR - http://ebooks.lib.ntu.edu.tw/1_file/ntsb/JRN0501/JRN0501.pdf UR - https://trid.trb.org/view/751150 ER - TY - RPRT AN - 00988095 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD. WE ARE ALL SAFER: LESSONS LEARNED AND LIVES SAVED 1975-2005. 3RD EDITION PY - 2005 SP - 58 p. AB - On April 1, 1975, the National Transportation Safety Board (NTSB) became a totally independent Federal agency. This report commemorates the 30th anniversary of the agency's independence and highlights some of the thousands of transportation safety improvements that have resulted from NTSB accident investigations and recommendations. Accidents have been prevented, lives saved, and injuries reduced because of NTSB-inspired safety advances in all modes of transportation: aviation, highway, marine, railroad and pipeline. The report also gives a brief history of the Safety Board, its responsibilities, and the legislation that created it, that strengthened its independence, and that has expanded its safety role over the years. Another section highlights the "Most Wanted List" and focuses on additional safety advances that the Safety Board strongly believes are needed to increase transportation safety. A list of the most prominent conferences and information-sharing meetings that have been sponsored by the Safety Board are included, as is a list of all 35 Board Members who have served on the Safety Board to date. KW - Aviation safety KW - Crash investigation KW - Crashes KW - Fatalities KW - Highway safety KW - History KW - Improvements KW - Injuries KW - Legislation KW - Lessons learned KW - Marine safety KW - Pipeline safety KW - Prevention KW - Railroad safety KW - Recommendations KW - Transportation safety KW - U.S. National Transportation Safety Board KW - United States UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR0501.pdf UR - https://trid.trb.org/view/753738 ER - TY - RPRT AN - 01016473 AU - National Transportation Safety Board TI - Railroad Accident Brief: CSX Freight Train Derailment and Subsequent Fire in the Howard Street Tunnel in Baltimore, Maryland, on July 18, 2001 PY - 2004/12/14 SP - 28p AB - On Wednesday, July 18, 2001, at 3:08 p.m., eastbound CSX1 freight train L-412-16 derailed 11 of its 60 cars while passing through the Howard Street Tunnel in Baltimore, Maryland. Four of the 11 derailed cars were tank cars: 1 contained tripropylene, a flammable liquid; 2 contained hydrochloric acid; and 1 contained di(2-ethylhexyl) phthalate, which is a plasticizer and an environmentally hazardous substance. The derailed tank car containing tripropylene was punctured, and the escaping tripropylene ignited. The fire spread to the contents of several adjacent cars, creating heat, smoke, and fumes that restricted access to the tunnel for several days. A 40-inch diameter water main directly above the tunnel broke in the hours following the accident and flooded the tunnel with millions of gallons of water. Five emergency responders sustained minor injuries while involved with the on-site emergency. Total costs associated with the accident, including response and clean-up costs, were estimated at about $12 million. The National Transportation Safety Board, after an exhaustive investigative effort, could not identify convincing evidence to explain the derailment of CSX freight train L-412-16 in the Baltimore, Maryland, Howard Street Tunnel on July 18, 2001. No preaccident equipment defects or rail defects were found. Computer simulations were used to evaluate locomotive event recorder data, train profile data, track profile data, and preaccident track geometry data. These simulations indicated that neither train operations nor changes in track conditions alone likely resulted in a derailment. Available physical evidence and computer simulations also showed that the most likely derailment scenario involved an obstruction between a wheel and the rail, in combination with changes in track geometry. However, postaccident fire, flooding, and necessary emergency response activities, including removing burning freight cars from the tunnel, significantly disturbed the accident site; and, no obstruction was identified that could be convincingly connected to wheel climb and evidence was insufficient to determine changes in track geometry. As a result of its investigation of the Howard Street Tunnel railroad accident, the National Transportation Safety Board makes the following safety recommendations: I. To CSX Transportation, Inc.: (1) Maintain historical documentation of maintenance and inspection activities affecting the Howard Street Tunnel (R-04-13); and (2) Take action necessary to enhance the exchange of information with the city of Baltimore on maintenance and construction activities within and in the vicinity of the Howard Street Tunnel (R-04-14). II. To the city of Baltimore, Maryland: (1) Take action necessary to enhance the exchange of information with CSX Transportation on maintenance and construction activities within and in the vicinity of the Howard Street Tunnel (R-04-15); and (2) Update and revise your emergency preparedness documents to include information on hazardous materials discharge response procedures specific to tunnel environments, as well as infrastructure information on the Howard Street Tunnel (R-04-16). KW - Baltimore (Maryland) KW - Computers KW - Construction KW - Costs KW - Crash causes KW - CSX Transportation KW - Derailments KW - Disaster preparedness KW - Disasters and emergency operations KW - Documentation KW - Emergency planning KW - Emergency response personnel KW - Environmental impacts KW - Fires KW - Flammable liquids KW - Floods KW - Fumes KW - Geometry KW - Hazardous chemicals KW - Heat KW - Howard Street Tunnel KW - Hydrochloric acid KW - Information exchange KW - Infrastructure KW - Injuries KW - Inspection KW - Maintenance KW - Obstructions KW - Plasticizers KW - Rail (Railroads) KW - Railroad crashes KW - Railroad safety KW - Railroad tracks KW - Recommendations KW - Simulation KW - Smoke KW - Tank cars KW - Tripropylene KW - Water mains KW - Wheels UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0408.pdf UR - https://trid.trb.org/view/771718 ER - TY - RPRT AN - 01014950 AU - National Transportation Safety Board TI - Hazardous Materials Accident Report: Rupture of a Railroad Tank Car Containing Hazardous Waste, Freeport, Texas, September 13, 2002 PY - 2004/12/01 SP - 38p AB - About 9:30 a.m. central daylight time on September 13, 2002, a 24,000-gallon-capacity railroad tank car, DBCX 9804, containing about 6,500 gallons of hazardous waste, catastrophically ruptured at a transfer station at the BASF Corporation chemical facility in Freeport, Texas. The tank car had been steamheated to permit the transfer of the waste to a highway cargo tank for subsequent disposal. The waste was a combination of cyclohexanone oxime, water, and cyclohexanone. As a result of the accident, 28 people received minor injuries, and residents living within 1 mile of the accident site had to shelter in place for 5 1/2 hours. The tank car, highway cargo tank, and transfer station were destroyed. Two storage tanks near the transfer station were damaged; they released about 660 gallons of the hazardous material oleum. The National Transportation Safety Board identified one major safety issue, the adequacy of procedures for heating hazardous materials cargoes in railroad tank cars before transfer. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Research and Special Programs Administration, the Occupational Safety and Health Administration, and the Environmental Protection Agency. KW - Crashes KW - Freeport (Texas) KW - Hazardous materials KW - Hazardous wastes KW - Injuries KW - Intermodal transfer KW - Oleum KW - Procedures KW - Railroad cars KW - Recommendations KW - Rupture KW - Steam heating KW - Storage tanks KW - Tank cars KW - Trucks UR - http://app.ntsb.gov/doclib/reports/2004/HZM0402.pdf UR - https://trid.trb.org/view/771560 ER - TY - RPRT AN - 00985806 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-37 PY - 2004/11/29 SP - 4 p. AB - This safety recommendation, addressed to the Honorable Norman Y. Mineta, Secretary, U.S. Department of Transportation, addresses the subject of medical oversight of noncommercial drivers. The National Transportation Safety Board (NTSB) examined six noncommercial vehicle accidents in which a driver's medical condition played a role and held a public hearing to discuss the factors that contribute to medically related accidents. The NTSB recommends that the U.S. Department of Transportation work with the U.S. Department of Health and Human Services, the U.S. Department of Labor, and the U.S. Department of Education to develop alternative transportation programs for medically impaired people of all ages who can no longer drive. KW - Alternatives analysis KW - Diseases and medical conditions KW - Drivers KW - Oversight KW - Recommendations KW - Traffic crashes KW - Transportation UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_37.pdf UR - https://trid.trb.org/view/747964 ER - TY - RPRT AN - 00985808 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-42 AND -43 PY - 2004/11/29 SP - 5 p. AB - These safety recommendations, addressed to Mr. John W. Archer, Chairman, National Committee on Uniform Traffic Laws and Ordinances, address the subject of medical oversight of noncommercial drivers. The National Transportation Safety Board (NTSB) examined six noncommercial vehicle accidents in which a driver's medical condition played a role and held a public hearing to discuss the factors that contribute to medically related accidents. The NTSB recommends that the National Committee on Uniform Traffic Laws and Ordinances (1) work with the National Association of Attorneys General to develop a model law that provides immunity from liability for any person (such as a healthcare worker, an emergency medical technician, a family member, or a concerned citizen) who, in good faith, reports a driver with a potentially impairing medical condition, and also encourage the States to include this law in their statutes and (2) develop model legislation, in conjunction with the National Association of Emergency Medical Technicians and the National Association of State EMS Directors, that allows information gathered by emergency medical technicians concerning the potential medical impairment of accident-involved drivers to be conveyed to the State licensing authority. KW - Diseases and medical conditions KW - Drivers KW - Emergency medical technicians KW - Laws KW - Legislation KW - Liability KW - Oversight KW - Recommendations KW - Reporting medical impairment KW - Traffic crashes UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_42_43.pdf UR - https://trid.trb.org/view/747966 ER - TY - RPRT AN - 00985812 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-48 PY - 2004/11/29 SP - 5 p. AB - This safety recommendation, addressed to Dr. James Thompson, Chief Executive Officer, Federation of State Medical Boards, addresses the need for improved awareness and training for health care professionals, law enforcement, and the public regarding State medical oversight laws and practices. The recommendation is derived from the National Transportation Safety Board's (NTSB's) special investigation into the medical oversight of noncommercial drivers and is consistent with the evidence found and the analysis performed. The NTSB recommends that the Federation of State Medical Boards work with member organizations to ensure that continuing medical education requirements in all States include a course addressing the driving risks associated with certain medical conditions and medications, as well as the existence and function of State reporting laws and procedures regarding medically impaired drivers. KW - Awareness KW - Diseases and medical conditions KW - Drivers KW - Education KW - Medical personnel KW - Oversight KW - Recommendations KW - Risk assessment KW - State laws KW - Training UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_48.pdf UR - https://trid.trb.org/view/747970 ER - TY - RPRT AN - 00985810 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-46 PY - 2004/11/29 SP - 4 p. AB - This safety recommendation, addressed to Mr. Sylvester Daughtry, Jr., Executive Director, Commission on Accreditation for Law Enforcement Agencies, addresses the need for improved awareness and training for health care professionals, law enforcement, and the public regarding State medical oversight laws and practices. The recommendation is derived from the National Transportation Safety Board's (NTSB's) special investigation into the medical oversight of noncommercial drivers and is consistent with the evidence found and the analysis performed. The NTSB recommends that the Commission on Accreditation for Law Enforcement Agencies work with the National Highway Traffic Safety Administration, the International Association of Directors of Law Enforcement Standards and Training, and the American Medical Association to develop a training program to help police officers identify common medical conditions that can impair a driver's ability to operate a motor vehicle and then promote this training to all new and veteran officers. KW - Awareness KW - Diseases and medical conditions KW - Drivers KW - Law enforcement personnel KW - Oversight KW - Police KW - Recommendations KW - Training UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_46.pdf UR - https://trid.trb.org/view/747968 ER - TY - RPRT AN - 00985809 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-44 AND -45 PY - 2004/11/29 SP - 7 p. AB - These safety recommendations, addressed to Mr. Mike Calvin, Senior Vice President, American Association of Motor Vehicle Administrators, address the subject of medical oversight of noncommercial drivers. The National Transportation Safety Board (NTSB) examined six noncommercial vehicle accidents in which a driver's medical condition played a role and held a public hearing to discuss the factors that contribute to medically related accidents. The NTSB recommends that the American Association of Motor Vehicle Administrators (1) modify the Driver Record Information Verification System to allow licensing agencies to ascertain current and previous medically related actions on a driver's license, as well as any current medically related license restrictions, and to ensure the timely transfer of medically related citation or accident information involving out-of-state drivers to the licensing State and (2) establish a standing medical evaluation unit working group to facilitate communication, standardization, and cooperation among medical evaluation units of member States. KW - Communication KW - Cooperation KW - Diseases and medical conditions KW - Driver licensing KW - Driver Record Information Verification System KW - Drivers KW - Medical evaluation working group KW - Medical license restrictions KW - Oversight KW - Recommendations KW - Standardization KW - Traffic crashes UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_44_45.pdf UR - https://trid.trb.org/view/747967 ER - TY - RPRT AN - 00985811 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-47 PY - 2004/11/29 SP - 5 p. AB - This safety recommendation, addressed to Dr. Jordan J. Cohen, President, Association of American Medical Colleges, Dr. Carol A. Aschenbrener, Secretary, Liaison Committee on Medical Education, Association of American Medical Colleges, and Dr. George Thomas, President, American Osteopathic Association, addresses the need for improved awareness and training for health care professionals, law enforcement, and the public regarding State medical oversight laws and practices. The recommendation is derived from the National Transportation Safety Board's (NTSB's) special investigation into the medical oversight of noncommercial drivers and is consistent with the evidence found and the analysis performed. The NTSB recommends that the Association of American Medical Colleges, the American Osteopathic Association, and the Liaison Committee on Medical Education require medical schools to teach students about the driving risks associated with certain medical conditions and medications, the existence and function of State reporting laws regarding medically high-risk drivers, and the methods and resources for counseling such drivers. KW - Awareness KW - Counseling KW - Diseases and medical conditions KW - Drivers KW - Education KW - Medical personnel KW - Medical schools KW - Oversight KW - Recommendations KW - Risk assessment KW - State laws KW - Training KW - Universities and colleges UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_47.pdf UR - https://trid.trb.org/view/747969 ER - TY - RPRT AN - 00985807 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-38 THROUGH -41 PY - 2004/11/29 SP - 6 p. AB - These safety recommendations, addressed to the Honorable Jeffrey W. Runge, MD, Administrator, National Highway Traffic Safety Administration, address the subject of medical oversight of noncommercial drivers. The National Transportation Safety Board (NTSB) examined six noncommercial vehicle accidents in which a driver's medical condition played a role and held a public hearing to discuss the factors that contribute to medically related accidents. The NTSB recommends that the National Highway Traffic Safety Administration in cooperation with the American Medical Association and the American Association of Motor Vehicle Administrators (1) develop a procedure to periodically collect, evaluate, and report data on a State and national basis, regarding the extent to which medical conditions contribute to the cause of accidents; and in cooperation with the American Association of Motor Vehicle Administrators (2) determine the most effective methods for the comprehensive reporting to State licensing authorities of drivers who may be medically impaired; (3) determine the most effective licensing countermeasures to reduce the risks posed by medically impaired drivers; and (4) once the most effective reporting methods and licensing countermeasures have been determined, develop a model comprehensive medical oversight program for States to use to oversee medically impaired drivers. KW - Data collection KW - Diseases and medical conditions KW - Driver licensing KW - Drivers KW - Medical oversight program KW - Oversight KW - Recommendations KW - Reporting methods KW - Traffic crashes UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_38_41.pdf UR - https://trid.trb.org/view/747965 ER - TY - RPRT AN - 00988136 AU - National Transportation Safety Board TI - HIGHWAY SPECIAL INVESTIGATION REPORT: MEDICAL OVERSIGHT OF NONCOMMERCIAL DRIVERS PY - 2004/11/09 SP - 104 p. AB - The National Transportation Safety Board's interest in the medical oversight of noncommercial drivers stems from its examination of six noncommercial vehicle accidents in which a driver's medical condition played a role. The Safety Board has also investigated a substantial number of commercial vehicle and school bus accidents involving drivers with impairing or potentially impairing medical conditions. As a result of its accident investigations and from its March 2003 public hearing, at which the factors that contribute to medically related accidents were discussed, the Safety Board identified the following safety issues: (1) Need for more data on the extent to which medical conditions contribute to the cause of accident; (2) Need for improved awareness and training for healthcare professionals, law enforcement, and the public regarding State medical oversight laws and practices; (3) Existence of barriers to the reporting of medically impaired drivers; (4) Lack of uniform medical assessment and oversight standards throughout the States; (5) Deficiencies in alternative transportation options for those who should not drive. The Safety Board has issued recommendations to the U. S. Department of Transportation, the National Highway Safety Administration, the National Committee on Uniform Traffic Laws and Ordinances, the American Association of Motor Vehicle Administrators, the Commission on Accreditation for Law Enforcement Agencies, the Liaison Committee on Medical Education, the American Osteopathic Association, the Association of American Medical Colleges, and the Federation of State Medical Boards. KW - Barriers to reporting KW - Crash causes KW - Crash data KW - Diseases and medical conditions KW - Drivers KW - Emergency medical technicians KW - Impaired drivers KW - Laws KW - Noncommercial drivers KW - Oversight KW - Paratransit services KW - Physicians KW - Public transit KW - Recommendations KW - Standards KW - Traffic crashes KW - Training UR - http://www.ntsb.gov/safety/safety-studies/Documents/SIR0401.pdf UR - https://trid.trb.org/view/753777 ER - TY - RPRT AN - 00988038 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT SEPARATION OF VERTICAL STABILIZER AMERICAN AIRLINES FLIGHT 587 AIRBUS INDUSTRIE A300-605R, N14053, BELLE HARBOR, NEW YORK, NOVEMBER 12, 2001 PY - 2004/10/26 SP - 210 p. AB - This report explains the accident involving American Airlines flight 587, an Airbus Industrie A300-605R, N14053, which crashed into a residential area of Belle Harbor, New York following the in-flight separation of the airplane's vertical stabilizer and rudder. The safety issues discussed in this report focus on characteristics of the A300-600 rudder control system design, A300-600 rudder pedal inputs at high airspeeds, aircraft-pilot coupling, flight operations at or below an airplane's design maneuvering speed, and upset recovery training programs. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration and the Direction General de l'Aviation Civile. KW - Air transportation crashes KW - Airbus Industrie KW - Aircraft pilot coupling KW - Airline pilots KW - Airspeed KW - American Airlines, Inc. KW - Aviation safety KW - Belle Harbor (New York) KW - Control KW - Design KW - Flight KW - In flight separation KW - Maneuvering KW - Operations KW - Pedals KW - Rudders KW - Speed KW - Training programs KW - Upset recovery KW - Vertical stabilizers UR - http://app.ntsb.gov/doclib/reports/2004/AAR0404.pdf UR - https://trid.trb.org/view/753686 ER - TY - RPRT AN - 00985797 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD URGENT SAFETY RECOMMENDATION, H-04-34 PY - 2004/10/21 SP - 10 p. AB - This safety recommendation, addressed to the Honorable Robert C. Bonner, Commissioner, U.S. Bureau of Customs and Border Protection, addresses the subject of immigration checkpoint operations on Interstate 87 near North Hudson, New York, which require all vehicles in both southbound traffic lanes to stop for a brief driver interview and possible inspection, causing traffic back ups and sometimes leading to accidents. Two such accidents are described. The National Transportation Safety Board recommends that the U.S. Bureau of Customs and Border Protection assist the Federal Highway Administration and the American Association of State Highway and Transportation Officials in immediately developing comprehensive traffic control guidelines specifically tailored to U.S. Border Patrol checkpoints located on high-speed arterial roadways and use those guidelines, once developed, as a basis for implementing traffic control at checkpoints nationwide. KW - Border regions KW - Guidelines KW - Interstate highways KW - Recommendations KW - Security checkpoints KW - Traffic congestion KW - Traffic control KW - Traffic crashes KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_34.pdf UR - https://trid.trb.org/view/747955 ER - TY - RPRT AN - 00985798 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD URGENT SAFETY RECOMMENDATION, H-04-35 AND -36 PY - 2004/10/21 SP - 10 p. AB - These safety recommendations, addressed to Mr. John Horsley, Executive Director, American Association of State Highway and Transportation Officials, address the subject of immigration checkpoint operations on Interstate 87 near North Hudson, New York, which require all vehicles in both southbound traffic lanes to stop for a brief driver interview and possible inspection, causing traffic back ups and sometimes leading to accidents. Two such accidents are described. The National Transportation Safety Board recommends that the American Association of State Highway and Transportation Officials (1) immediately develop, with the assistance of the Federal Highway Administration and U.S. Bureau of Customs and Border Protection, comprehensive traffic control guidelines specifically tailored to U.S. Border Patrol checkpoints located on high-speed arterial roadways and (2) assist the Federal Highway Administration in incorporating these guidelines into the "Manual on Uniform Traffic Control Devices." KW - Border regions KW - Guidelines KW - Interstate highways KW - Manual on Uniform Traffic Control Devices KW - Recommendations KW - Security checkpoints KW - Traffic congestion KW - Traffic control KW - Traffic crashes KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_35_36.pdf UR - https://trid.trb.org/view/747956 ER - TY - RPRT AN - 00985796 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD URGENT SAFETY RECOMMENDATION, H-04-32 AND -33 PY - 2004/10/21 SP - 10 p. AB - These safety recommendations, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration, address the subject of immigration checkpoint operations on Interstate 87 near North Hudson, New York, which require all vehicles in both southbound traffic lanes to stop for a brief driver interview and possible inspection, causing traffic back ups and sometimes leading to accidents. Two such accidents are described. The National Transportation Safety Board recommends that the Federal Highway Administration (1) assist the American Association of State Highway and Transportation Officials and the U.S. Bureau of Customs and Border Protection in immediately developing comprehensive traffic control guidelines specifically tailored to U.S. Border Patrol checkpoints located on high-speed arterial roadways and (2) incorporate, in cooperation with the American Association of State Highway and Transportation Officials, these guidelines into the "Manual on Uniform Traffic Control Devices." KW - Border regions KW - Guidelines KW - Interstate highways KW - Manual on Uniform Traffic Control Devices KW - Recommendations KW - Security checkpoints KW - Traffic congestion KW - Traffic control KW - Traffic crashes KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_32_33.pdf UR - https://trid.trb.org/view/747954 ER - TY - RPRT AN - 01014940 AU - National Transportation Safety Board TI - Aircraft Accident Report: In-Flight Engine Failure and Subsequent Ditching, Air Sunshine, Inc., Flight 527, Cessna 402C, N314AB, About 7.35 Nautical Miles West-Northwest of Treasure Cay Airport, Great Abaco Island, Bahamas, July 13, 2003 PY - 2004/10/13 SP - 60p AB - This report explains the accident involving Air Sunshine, Inc., flight 527, a Cessna 402C, which experienced an in-flight engine failure and was subsequently ditched about 7.35 nautical miles west-northwest of Treasure Cay Airport, Great Abaco Island, Bahamas. The safety issues discussed in this report include maintenance record-keeping and practices, pilot proficiency, Federal Aviation Administration (FAA) oversight, and emergency briefings. A safety recommendation concerning emergency briefings is addressed to the FAA. KW - Air pilots KW - Air Sunshine KW - Air transportation crashes KW - Aircraft engines KW - Aviation safety KW - Bahamas KW - Cessna aircraft KW - Disaster preparedness KW - Failure KW - Maintenance KW - Oversight KW - Proficiency KW - Recommendations KW - Recordkeeping KW - U.S. Federal Aviation Administration UR - http://app.ntsb.gov/doclib/reports/2004/AAR0403.pdf UR - https://trid.trb.org/view/771554 ER - TY - RPRT AN - 01014947 AU - National Transportation Safety Board TI - Pipeline Accident Report: Storage Tank Explosion and Fire in Glenpool, Oklahoma, April 7, 2003 PY - 2004/10/13 SP - 52p AB - About 8:55 p.m., central daylight time, on April 7, 2003, an 80,000-barrel storage tank at ConocoPhillips Company’s Glenpool South tank farm in Glenpool, Oklahoma, exploded and burned as it was being filled with diesel. Gasoline had been removed from the tank earlier in the day. The resulting fire burned for about 21 hours and damaged two other storage tanks in the area. The cost of the accident was $2,357,483. There were no injuries or fatalities. Nearby residents were evacuated, and schools were closed for 2 days. The safety issues identified in this accident are tank operations, including switch loading, at the ConocoPhillips Company tank farm; the adequacy of emergency planning and emergency response by ConocoPhillips and American Electric Power; and the adequacy of Federal regulations and industry standards for emergency planning. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Research and Special Programs Administration, ConocoPhillips Company, American Electric Power, the American Society of Mechanical Engineers, and the Institute of Electrical and Electronics Engineers. KW - ConocoPhillips Company KW - Costs KW - Diesel fuels KW - Disasters and emergency operations KW - Emergency planning KW - Evacuation KW - Explosions KW - Federal government KW - Fires KW - Gasoline KW - Oklahoma KW - Operations KW - Pipeline accidents KW - Pipeline safety KW - Pipelines KW - Regulations KW - Standards KW - Storage tanks KW - Switch loading UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0402.pdf UR - https://trid.trb.org/view/771511 ER - TY - RPRT AN - 00985786 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-31 PY - 2004/09/09 SP - 5 p. AB - This safety recommendation, addressed to Mr. John Horsley, Executive Director, American Association of State Highway and Transportation Officials, addresses motorist warning systems to stop traffic in the event of a bridge collapse. The recommendation results from the investigation of an accident where a tow boat veered off course and struck a pier, causing a bridge section to collapse and, without any warning, motorists to continue to drive into the void created by the collapse. The National Transportation Safety Board recommends that the American Association of State Highway and Transportation Officials, once an effective motorist warning system has been developed, provide guidance to the States on its use. KW - Bridge piers KW - Collapse KW - Crash investigation KW - Crashes KW - Recommendations KW - Towboats KW - Traffic control KW - Vessel impact KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_31.pdf UR - https://trid.trb.org/view/747943 ER - TY - RPRT AN - 00985785 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-29 AND -30 PY - 2004/09/09 SP - 6 p. AB - These safety recommendations, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration, address the subjects of bridge protection, specifically the vulnerability of existing bridges to vessel impacts and other extreme events, and an effective warning system to stop traffic in the event of a bridge collapse. The recommendations result from the investigation of an accident where a tow boat veered off course and struck a pier, causing a bridge section to collapse and, without any warning, motorists to continue to drive into the void created by the collapse. The National Transportation Safety Board recommends that the Federal Highway Administration (1) revise its sufficiency rating system, which prioritizes bridges for rehabilitation and replacement, to include the probability of extreme events, such as vessel impact and (2) develop an effective motorist warning system to stop motor vehicle traffic in the event of a partial or total bridge collapse. KW - Bridge piers KW - Collapse KW - Crash investigation KW - Crashes KW - Recommendations KW - Revisions KW - Sufficiency rating KW - Towboats KW - Traffic control KW - Vessel impact KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_29_30.pdf UR - https://trid.trb.org/view/747942 ER - TY - RPRT AN - 01003097 AU - National Transportation Safety Board TI - Marine Accident Brief: Engineroom Fire on the U.S. Passenger Vessel Columbia in Wrangell Narrows, Near Wrangell, Alaska, on May 28, 2003 PY - 2004/08/31 SP - 5p AB - About 1:21 a.m. on May 28, 2003, the Alaska Marine Highway System ferry Columbia, departed Petersburg, Alaska, en route to Wrangell, Alaska. The ferry had three ship-service diesel generators located in the auxiliary engine room. Shortly after the Columbia left port, a fire was discovered in the area of the No. 2 generator's cooling fan ports and beneath the turbocharger of the No. 2 generator's diesel engine. Two members of the firefighting team discovered that the air filter on the turbocharger of the generator was on fire, producing billowing smoke. The burning air filter was removed from the air intake, and the fire was extinguished. After electrical power was fully restored, the crew restarted the two main engines and the voyage to Wrangell was resumed. An initial examination of generator No. 2 showed that much of the copper wiring in the lower part of the generator had melted and vaporized. In an in-depth failure analysis, the remaining windings were removed and inspected for evidence of improper assembly or insulation failures. The examiner concluded that the insulation breakdown had occurred in the lower part of the generator, which had been mostly destroyed. He further concluded that a previous electrical event had caused aging or hard spots in at least one of the windings near the bottom of the generator. This caused a short between turns which increased the current in that coil. The heat was eventually enough to cause additional turns to become shorted and then to start the melting process in the winding. As the molten copper started to flow, it shorted windings phase to phase, and the event quickly became a catastrophic failure. The National Transportation Safety Board determines that the probable cause of the fire and the destruction of the wiring in the No. 2 ship-service generator on the Columbia was a breakdown in the generator's wiring insulation. KW - Alaska KW - Alaska Marine Highway System KW - Copper KW - Diesel engines KW - Ferries KW - Fire causes KW - Generators KW - Insulation systems KW - Water transportation crashes KW - Wiring UR - http://app.ntsb.gov/doclib/reports/2004/MAB0402.pdf UR - https://trid.trb.org/view/759252 ER - TY - RPRT AN - 00985784 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-27 AND -28 PY - 2004/08/30 SP - 5 p. AB - These safety recommendations, addressed to Ms. Susan E. McCarthy, City Manager, City of Santa Monica, address the subjects of temporary rigid barriers between pedestrians and vehicles and temporary traffic plans for roadway closures. The recommendations result from the investigation of an accident where the elderly driver failed to maintain control of his vehicle due to his unintended acceleration, struck a stopped vehicle, and drove through a farmers' market, fatally injuring 10 people and inflicting serious or minor injury on 63 people. The National Transportation Safety Board recommends that the city of Santa Monica, California, (1) install a temporary rigid barrier system at the closure limits of the Santa Monica Certified Farmers' Market to provide a physical barrier to errant vehicles entering the market and (2) update its temporary traffic plans for roadway closures to ensure the safe operation of the city's certified farmers' markets and review and evaluate the adequacy of the plans annually. KW - Aged drivers KW - Barriers (Roads) KW - Crash investigation KW - Fatalities KW - Injuries KW - Loss of control KW - Pedestrian safety KW - Pedestrian-vehicle crashes KW - Recommendations KW - Santa Monica (California) KW - Street closure KW - Temporary structures KW - Traffic control UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_27_28.pdf UR - https://trid.trb.org/view/747941 ER - TY - RPRT AN - 00985782 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-25 PY - 2004/08/30 SP - 2 p. AB - This safety recommendation, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration, addresses the subject of positive barriers between pedestrians and vehicles. This recommendation results from the investigation of an accident where the elderly driver failed to maintain control of his vehicle due to his unintended acceleration, struck a stopped vehicle, and drove through a farmers' market, fatally injuring 10 people and inflicting serious or minor injury on 63 people. The National Transportation Safety Board recommends that the Federal Highway Administration revise the "Manual on Uniform Traffic Control Devices," Chapter 6, "Temporary Traffic Control," to provide specific references and guidance on the use of barricades, barriers, crash cushions, and other devices, as appropriate, for road closure situations other than highway construction or maintenance. KW - Aged drivers KW - Barricades KW - Barriers (Roads) KW - Crash cushions KW - Crash investigation KW - Fatalities KW - Injuries KW - Loss of control KW - Manual on Uniform Traffic Control Devices KW - Pedestrian safety KW - Pedestrian-vehicle crashes KW - Recommendations KW - Revisions KW - Street closure KW - Temporary structures UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_25.pdf UR - https://trid.trb.org/view/747939 ER - TY - RPRT AN - 00985783 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-26 PY - 2004/08/30 SP - 3 p. AB - This safety recommendation, addressed to the Honorable Jeffrey W. Runge, MD, Administrator, National Highway Traffic Safety Administration, addresses the subject of event data recorders (EDRs). This recommendation results from the investigation of an accident where the elderly driver failed to maintain control of his vehicle due to his unintended acceleration, struck a stopped vehicle, and drove through a farmers' market, fatally injuring 10 people and inflicting serious or minor injury on 63 people. The National Transportation Safety Board recommends that the National Highway Traffic Safety Administration, once standards for EDRs are developed, require their installation in all newly manufactured light-duty vehicles. KW - Aged drivers KW - Crash data KW - Crash investigation KW - Event data recorders KW - Fatalities KW - Injuries KW - Light vehicles KW - Loss of control KW - Pedestrian-vehicle crashes KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_26.pdf UR - https://trid.trb.org/view/747940 ER - TY - RPRT AN - 00982196 AU - National Transportation Safety Board TI - REAR-END COLLISION AND SUBSEQUENT VEHICLE INTRUSION INTO PEDESTRIAN SPACE AT CERTIFIED FARMERS' MARKET, SANTA MONICA, CALIFORNIA, JULY 16, 2003 PY - 2004/08/03 SP - 57 p. AB - On July 16, 2003, a 1992 Buick LeSabre was westbound on Arizona Avenue, approaching the intersection of Fourth Street, in Santa Monica, California. A 2003 Mercedes Benz S430 sedan was stopped on Arizona Avenue at the intersection for pedestrians in a crosswalk on Fourth Street. The Buick struck the Mercedes, continued through the intersection, and drove through a farmers' market, striking pedestrians and vendor displays before coming to rest. As a result of the accident 10 people were fatally injured, and 63 people received injuries ranging from minor to serious. The Buick driver and both Mercedes occupants were uninjured. The major safety issues discussed in this report are the unintended acceleration of the accident vehicle, the adequacy of temporary traffic control measures for the protection of pedestrian traffic in the Santa Monica Certified Farmers' Market, and the need to equip motor vehicles with event data recorders. As a result of its investigation, the Safety Board made recommendations to the Federal Highway Administration, the National Highway Traffic Safety Administration, and the city of Santa Monica. KW - Event data recorders KW - Fatalities KW - Injuries KW - Pedestrian safety KW - Pedestrian-vehicle crashes KW - Rear end crashes KW - Santa Monica (California) KW - Santa Monica Certified Farmers' Market KW - Traffic control KW - Unintended vehicle acceleration UR - http://app.ntsb.gov/doclib/reports/2004/HAR0404.pdf UR - https://trid.trb.org/view/743294 ER - TY - RPRT AN - 01014944 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Release of Hazardous Materials From Cargo Tank in Middletown, Ohio, on August 22, 2003 PY - 2004/07/22 SP - 10p AB - At 7:17 a.m., on August 22, 2003, an Amerigas Corporation (Amerigas) cargo tank semitrailer arrived at the AK Steel Corporation (AK Steel) facility in Middletown, Ohio. The driver pulled the vehicle up to the fill location and helped an AK Steel employee hook up to the fittings for a plant storage tank. According to the driver, about 7:40 a.m., the AK Steel employee began transferring anhydrous ammonia, a poisonous and corrosive gas, from the storage tank to the cargo tank. The driver said that it took about 30 minutes to equalize the pressure between the storage tank and the cargo tank. He said that once the pressure was equalized, the internal pressure in the cargo tank was 130 pounds per square inch gauge (psig). About 8:20 a.m., while the cargo tank was still being loaded, its front head cracked open, releasing vapor. The driver, who had been resting in the tractor, got out and saw the escaping vapor. He said that he activated the emergency shut off device for the cargo tank and that according to the gauges, the cargo tank was a little less than half full, the internal pressure was about 170 psig, and the temperature of the anhydrous ammonia was 80 degrees F. About 100 employees and contract workers were evacuated from the buildings downwind of the cargo tank and moved to safer locations. Five people were treated for inhalation injuries and released. The cost of repairing and replacing damaged equipment was about $25,000. The National Transportation Safety Board determines that the probable cause of this accident was the failure of AK Steel Corporation to establish and implement loading procedures that would prohibit using a cargo tank manufactured of quenched and tempered steel to transport anhydrous ammonia containing less than 0.2 percent water by weight, resulting in stress-corrosion cracking and tank failure. Contributing to the cause of the accident was Amerigas Corporation's failure to tell its drivers that anhydrous ammonia containing less than 0.2 percent water by weight should not be loaded into cargo tanks manufactured of quenched and tempered steel. KW - Amerigas Corporation KW - Anhydrous ammonia KW - Cargo handling KW - Cargo tank head fracture KW - Corrosion KW - Costs KW - Cracking KW - Crash causes KW - Crashes KW - Evacuation KW - Hazardous materials KW - Injuries KW - Loading and unloading KW - Middletown (Ohio) KW - Poisonous gases KW - Pressure KW - Procedures KW - Quenched and tempered steel KW - Storage tanks KW - Stresses KW - Tank trucks KW - Tractor trailer combinations KW - Vapors UR - http://app.ntsb.gov/doclib/reports/2004/HZB0401.pdf UR - https://trid.trb.org/view/771580 ER - TY - RPRT AN - 00979274 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: COLLISION OF TWO CHICAGO TRANSIT AUTHORITY TRAINS, CHICAGO, ILLINOIS, FEBRUARY 3, 2004 PY - 2004/07/07 SP - 5 p. AB - On February 3, 2004, at 5:46 p.m., a northbound Chicago Transit Authority (CTA) Purple Line train 509 collided with the rear car of standing Brown Line train 419. The collision occurred just north of the Merchandise Mart passenger platform during the evening rush hour in Chicago, Illinois. The trains were operating in automatic train control cab signal territory. The collision occurred on track that is elevated about 20 feet from street level on a series of open deck bridges. No cars derailed as a result of the collision, but 42 passengers sustained minor injuries. A third train neared the striking train but stopped short of a second rear-end collision. Weather conditions were clear and dark; the temperature was 18 deg F. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the operator of train 509 to comply with operating rules. Contributing to the accident was inadequate operational safety oversight by Chicago Transit Authority. KW - Chicago (Illinois) KW - Chicago Transit Authority KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Operating rules KW - Oversight KW - Passenger trains KW - Railroad crashes KW - Railroad safety KW - Rear end crashes KW - Train operations KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0407.pdf UR - https://trid.trb.org/view/740538 ER - TY - RPRT AN - 00985774 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-21 PY - 2004/07/06 SP - 3 p. AB - This safety recommendation, addressed to Major General Ann E. Dunwoody, Commanding General, U.S. Department of Defense, Surface Deployment and Distribution Command, addresses the effective identification and prevention of unsafe passenger carrier operations. The recommendation is derived from the investigation of the June 23, 2002, motorcoach run-off-the-road and rollover accident off Interstate 90 near Victor, New York, and is consistent with the evidence found and the analysis performed by the National Transportation Safety Board (NTSB). The NTSB determined that the probable cause of the accident was that the bus driver fell asleep while operating the motorcoach due to his deliberate failure to obtain adequate rest during his off-duty hours. The NTSB recommends that the U.S. Department of Defense Surface Deployment and Distribution Command provide motor carrier information, including timely results of passenger carrier inspection processes and ratings, to the Federal Motor Carrier Safety Administration. KW - Bus crashes KW - Bus drivers KW - Bus lines KW - Crash investigation KW - Fatigue (Physiological condition) KW - Inspection KW - Personnel management KW - Ran off road crashes KW - Ratings KW - Recommendations KW - Rollover crashes UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_21.pdf UR - https://trid.trb.org/view/747930 ER - TY - RPRT AN - 00985775 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-22 PY - 2004/07/06 SP - 4 p. AB - This safety recommendation, addressed to Mr. Dale Moser, Chief Operating Officer, North Central Region, Coach USA, addresses the evaluation of all telephone calls reporting unsafe drivers to motor carriers. The recommendation is derived from the investigation of the June 23, 2002, motorcoach run-off-the-road and rollover accident off Interstate 90 near Victor, New York, and is consistent with the evidence found and the analysis performed by the National Transportation Safety Board (NTSB). The NTSB determined that the probable cause of the accident was that the bus driver fell asleep while operating the motorcoach due to his deliberate failure to obtain adequate rest during his off-duty hours. The NTSB recommends that Coach USA and its subsidiaries evaluate all calls reporting dangerous driver behaviors immediately upon receiving them and establish a method to reach the driver so that Coach USA can evaluate the driver's fitness for duty and take appropriate countermeasures, if necessary. KW - Bus crashes KW - Bus drivers KW - Bus lines KW - Countermeasures KW - Crash investigation KW - Fatigue (Physiological condition) KW - Oversight KW - Physical fitness KW - Ran off road crashes KW - Recommendations KW - Rollover crashes UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_22.pdf UR - https://trid.trb.org/view/747931 ER - TY - RPRT AN - 01014953 AU - National Transportation Safety Board TI - Pipeline Accident Report: Rupture of Enbridge Pipeline and Release of Crude Oil near Cohasset, Minnesota, July 4, 2002 PY - 2004/06/23 SP - 44p AB - About 2:12 a.m., central daylight time, on July 4, 2002, a 34-inch-diameter steel pipeline owned and operated by Enbridge Pipelines, LLC ruptured in a marsh west of Cohasset, Minnesota. Approximately 6,000 barrels (252,000 gallons) of crude oil were released from the pipeline as a result of the rupture. The cost of the accident was reported to the Research and Special Programs Administration Office of Pipeline Safety to be approximately $5.6 million. No deaths or injuries resulted from the release. The safety issues identified in this accident are the effectiveness and application of line pipe transportation standards and the adequacy of Federal requirements for pipeline integrity management programs. As a result of its investigation of this accident, the Safety Board issues safety recommendations to the Research and Special Programs Administration, the American Society of Mechanical Engineers, and the American Petroleum Institute. KW - Costs KW - Crude oil KW - Federal government KW - Minnesota KW - Pipeline accidents KW - Pipeline integrity management KW - Pipeline safety KW - Pipeline transportation KW - Pipelines KW - Recommendations KW - Rupture KW - Standards KW - Steel UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0401.pdf UR - https://trid.trb.org/view/771514 ER - TY - RPRT AN - 00982081 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: MOTORCOACH RUN-OFF-THE-ROAD AND ROLLOVER OFF INTERSTATE 90, VICTOR, NEW YORK, JUNE 23, 2002 PY - 2004/06/22 SP - 71 p. AB - On June 23, 2002, a 55-passenger Motor Coach Industries, Inc., motorcoach was traveling eastbound on Interstate 90 near Victor, New York. As it approached the Victor Exit 45 ramp, the bus departed the road; struck a W-beam guardrail, dragging about 700 ft of it across the eastbound entrance ramp; vaulted over the entrance ramp, landing on the ramp's south side shoulder; and rolled 90 deg onto its right side, sliding to rest. The guardrail dragged by the bus during the accident sequence struck three eastbound vehicles on the entrance ramp. Three occupants of these vehicles were uninjured, and six received minor injuries. Of the 48 people on the motorcoach, 5 passengers were killed; the driver and 41 passengers sustained injuries; and 1 passenger was uninjured. The safety issues discussed in this report are operator fatigue, motorcoach crashworthiness, and the adequacy of the Federal Motor Carrier Safety Administration's oversight of and rating system for motorcoach operations. As a result of its investigation, the Safety Board makes new recommendations to the Federal Motor Carrier Safety Administration, the U.S. Department of Defense Surface Deployment and Distribution Command, and Coach USA. Also, the Board reiterates Safety Recommendations H-99-47 and -48 to the National Highway Traffic Safety Administration. KW - Bus crashes KW - Bus drivers KW - Buses KW - Crashworthiness KW - Fatalities KW - Fatigue (Physiological condition) KW - Injuries KW - Interstate highways KW - Off ramps KW - Oversight KW - Ran off road crashes KW - Recommendations KW - Rollover crashes KW - U.S. Federal Motor Carrier Safety Administration KW - Victor (New York) UR - http://app.ntsb.gov/doclib/reports/2004/HAR0403.pdf UR - https://trid.trb.org/view/743235 ER - TY - RPRT AN - 00976370 AU - National Transportation Safety Board TI - HAZARDOUS MATERIALS ACCIDENT REPORT : NURSE TANK FAILURE WITH RELEASE OF HAZARDOUS MATERIALS NEAR CALAMUS, IOWA, APRIL 15, 2003 PY - 2004/06/22 SP - 38 p. AB - About 11:50 a.m. central daylight time on April 15, 2003, a nonspecification cargo tank used by River Valley Cooperative (River Valley) exclusively for agricultural purposes as a nurse tank split open after being filled with anhydrous ammonia at River Valley's nurse tank filling facility near Calamus, Iowa. About 1,300 gallons of the poisonous and corrosive gas escaped, seriously injuring two nurse tank loaders, one of whom died from his injuries 9 days after the accident. Equipment repair and replacement costs associated with the accident totaled about $3,100. As a result of its investigation of the accident, the National Transportation Safety Board identified the following major safety issues: the adequacy of standards for initial qualification and periodic testing of nurse tanks, and the adequacy of River Valley's emergency procedures for anhydrous ammonia nurse tank loaders. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Research and Special Programs Administration and River Valley. KW - Ammonia KW - Corrosive materials KW - Costs KW - Crash analysis KW - Crash causes KW - Crash characteristics KW - Crash investigation KW - Emergency management KW - Fatalities KW - Hazardous materials KW - Injuries KW - Iowa KW - Nurse tanks KW - Poisonous gases KW - Recommendations KW - Repairing KW - Standards KW - Testing UR - http://app.ntsb.gov/doclib/reports/2004/HZM0401.pdf UR - https://trid.trb.org/view/702909 ER - TY - RPRT AN - 00979275 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: COLLISION OF THREE UNION PACIFIC FREIGHT TRAINS AT PACIFIC, MISSOURI, DECEMBER 13, 2001 PY - 2004/06/17 SP - 6 p. AB - About 5:46 a.m. on December 13, 2001, three Union Pacific freight trains were involved in a collision and derailment on the Jefferson City Subdivision at Pacific, Missouri, about 35 miles southwest of St. Louis. The collision occurred in double main track territory governed by a centralized traffic control signal system. In total 6 locomotives and 74 cars were derailed. There were two crewmembers on each of the three trains. Two crewmembers were seriously injured, and two received minor injuries. There was a release of 10,000 gallons of diesel fuel and a small fire. Damages were $10 million. The weather was overcast with misting rain and a temperature of 36 deg F. It was dark at the time of the collision. The National Transportation Safety Board determined that the probable cause of the rear-end collision of eastbound train CNRBW-10 with eastbound train 2CNAAE-10 and the resulting collision of westbound train CPAWE-13 was the conductor and engineer of train CNRBW-10 being in a fatigue-induced unresponsive state as their train passed several wayside signals and approached the rear of train 2CNAAE-10. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Derailments KW - Fatigue (Physiological condition) KW - Freight trains KW - Human factors in crashes KW - Missouri KW - Railroad crashes KW - Rear end crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0406.pdf UR - https://trid.trb.org/view/740539 ER - TY - RPRT AN - 00977167 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: COLLISION WITH TREES ON FINAL APPROACH, FEDERAL EXPRESS FLIGHT 1478, BOEING 727-232, N497FE, TALLAHASSEE, FLORIDA, JULY 26, 2002 PY - 2004/06/08 SP - 128 p. AB - This report explains the accident involving Federal Express flight 1478, a Boeing 727-232F, N497FE, which struck trees on short final approach and crashed short of runway 9 at the Tallahassee Regional Airport, Tallahassee, Florida. Safety issues in this report focus on flight crew performance, flight crew decision-making, pilot fatigue, and Federal Aviation Administration (FAA) certification of pilots with color vision deficiencies. Safety recommendations concerning these issues are addressed to the FAA. KW - Air pilots KW - Air transportation crashes KW - Certification KW - Color vision KW - Decision making KW - Fatigue (Physiological condition) KW - Flight crews KW - Performance UR - http://app.ntsb.gov/doclib/reports/2004/AAR0402.pdf UR - https://trid.trb.org/view/703241 ER - TY - RPRT AN - 01014931 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Uncontrolled Descent and Impact with Terrain, Eurocopter AS350-B2 Helicopter, N169PA, Meadview, Arizona, August 10, 2001 PY - 2004/06/03 SP - 47p AB - On August 10, 2001, about 1428 mountain standard time, a Eurocopter AS350-B2 helicopter, N169PA, operating as Papillon 34, collided with terrain during an uncontrolled descent about 4 miles east of Meadview, Arizona. The helicopter was operated by Papillon Airways, Inc., as an air tour flight under Code of Federal Regulations 14 (CFR) Part 135. The helicopter was destroyed by impact forces and a postcrash fire. The pilot and five passengers were killed, and the remaining passenger sustained serious injuries. The flight originated from the company terminal at the McCarran International Airport (LAS), Las Vegas, Nevada, about 1245 as a tour of the west Grand Canyon area with a planned stop at a landing site in Quartermaster Canyon. The helicopter departed the landing site about 1400 and stopped at a company fueling facility at the Grand Canyon West Airport (GCW). The helicopter departed the fueling facility at 1420 and was en route to LAS when the accident occurred. Visual meteorological conditions prevailed, and a visual flight rules flight plan was filed. The National Transportation Safety Board determines that the probable cause of this accident was the pilot's decision to maneuver the helicopter in a flight regime and in a high density altitude environment which significantly decreased the helicopter's performance capability, resulting in a high rate of descent from which recovery was not possible. Factors contributing to the accident were high density altitude and the pilot's decision to maneuver the helicopter in proximity to precipitous terrain, which effectively limited remedial options available. KW - Air pilots KW - Air transportation crashes KW - Altitude KW - Aviation safety KW - Crash causes KW - Fatalities KW - Helicopters KW - High density KW - Injuries KW - Meadview (Arizona) KW - Performance KW - Terrain KW - Uncontrolled descent (Aircraft) KW - Visual flight UR - https://www.ntsb.gov/doclib/reports/2004/AAB0402.pdf UR - https://trid.trb.org/view/771555 ER - TY - RPRT AN - 00979276 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: DERAILMENT OF AMTRAK TRAIN NO. 30, THE CAPITOL LIMITED, ON CSX TRANSPORTATION'S METROPOLITAN SUBDIVISION IN KENSINGTON, MARYLAND, JULY 29, 2002 PY - 2004/05/28 SP - 8 p. AB - About 1:55 p.m., on July 29, 2002, eastbound National Railroad Passenger Corporation (Amtrak) train No. 30, the Capitol Limited, derailed on CSX Transportation's (CSXT) Metropolitan Subdivision at milepost 11.78 in Kensington, Maryland. The train had originated in Chicago and was en route to Washington, D.C. The train comprised 2 locomotives and 13 cars and was moving at 60 mph on tangent (straight) track in the area of the derailment. Eleven cars derailed. Of the 164 passengers and 13 Amtrak crewmembers on board, 14 passengers and 2 Amtrak crewmembers received serious injuries. An additional 71 passengers and 8 Amtrak crewmembers sustained minor injuries. Estimated damages exceeded $14.3 million. The weather was clear and sunny, with temperatures reaching a high of 96 deg F. The National Transportation Safety Board determined that the probable cause of the derailment was (1) the failure of the track surfacing crew to adequately tamp the ballast and accomplish a proper run-off, leading to an unstable condition and buckled track, (2) an incorrect slow order code indicating that the work was complete when it was not, and (3) inadequate CSXT oversight of track maintenance work on this section of track. CSXT has, since this accident, implemented a number of revisions to its track surfacing policies, procedures, and training. KW - Amtrak KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - CSX Transportation KW - Derailments KW - Injuries KW - Maintenance management KW - Maryland KW - Oversight KW - Passenger trains KW - Railroad crashes KW - Railroad tracks KW - Surfacing KW - Tamping KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0405.pdf UR - https://trid.trb.org/view/740540 ER - TY - RPRT AN - 00979277 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: COLLISION AND DERAILMENT OF UNION PACIFIC FREIGHT TRAINS MPRSS-21 AND AJAPRB-21 AT DES PLAINES, ILLINOIS, OCTOBER 21, 2002 PY - 2004/05/27 SP - 5 p. AB - About 10:38 p.m., on October 21, 2002, westbound Union Pacific Railroad (UP) train MPRSS-21 struck eastbound UP train AJAPRB-21, which was moving through a crossover at Norma Interlocking in Des Plaines, Illinois. The lead 3 locomotives of the striking train, as well as 6 cars positioned 20 cars behind the locomotives, derailed. Three cars of train AJAPRB-21 derailed, and three others were damaged. About 5,000 gallons of diesel fuel from the derailed locomotives spilled onto the ground. The two crewmembers of the striking train sustained non-life-threatening injuries. Damages were $1.02 million. The National Transportation Safety Board determines that the probable cause of the collision of train MPRSS-21 with train AJAPRB-21 was the train MPRSS-21 engineer falling asleep at the controls of his locomotive and the unexplained inattentiveness and inaction of the conductor in the moments before the collision. Contributing to the engineer falling asleep was likely his use of prescription medications that may cause drowsiness, as well as his lack of sleep in the 22 hours preceding the accident. KW - Attention lapses KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Derailments KW - Drowsiness KW - Fatigue (Physiological condition) KW - Freight trains KW - Human factors in crashes KW - Illinois KW - Medication KW - Railroad crashes KW - Side crashes KW - Sleep deprivation KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0404.pdf UR - https://trid.trb.org/view/740541 ER - TY - RPRT AN - 01003125 AU - National Transportation Safety Board TI - Marine Accident Brief: Grounding and Sinking of U.S. Passenger Vessel Safari Spirit, Kisameet Bay off Fisher Channel, about 20 miles Southeast of the Towns of Bella Bella and Shearwater, Denny Island, British Columbia, Canada on May 8, 2003 PY - 2004/04/22 SP - 10p AB - On May 8, 2003, the uninspected U.S. passenger vessel Safari Spirit, a luxury yacht owned and operated by American Safari Cruises, ran aground of a submerged rock in Kisameet Bay near British Columbia, as it attempted to leave the bay after anchoring there overnight. The yacht smoothly rode up on the rock, and then became hard aground. The master attempted unsuccessfully to free the vessel from its strand by running the main engines full astern. As the tide ebbed, the vessel became more firmly grounded. While passengers were preparing to evacuate the ship, the vessel suddenly, and unexpectedly, listed hard over on its starboard side. Everyone but the master evacuated the vessel at once and transferred to the yacht's skiff until picked up by rescue boats. A kedge anchor was rigged and placed off the port bow in an attempt to hold the vessel in place and prevent it from sliding off the rock. As the tide level dropped, water flooded the vessel. As the yacht trimmed aft, the ground reaction force holding the vessel decreased, and the Safari Spirit slipped stern first off the rock and sank in about 70 feet of water. In total, the costs related to the accident were about $3,200,000. The National Transportation Safety Board determines that the probable cause of the grounding of the Safari Spirit was the failure of the vessel’s master to use appropriate navigational procedures and equipment to determine the vessel’s position while transiting Kisameet Bay. Contributing to the cause of the grounding was the failure of American Safari Cruises to have and require its masters to use a voyage planning and procedure manual detailing port/anchorage selection criteria, identifying hazards and risks in vessel operating areas, and setting forth safety guidelines for mitigating risks and hazards. KW - American Safari Cruises KW - British Columbia KW - Groundings (Maritime crashes) KW - Kisameet Bay KW - Maritime safety KW - Navigational aids KW - Passenger ships KW - Risk management KW - Ship pilotage KW - Sinking (Oceanography) KW - Water transportation crashes KW - Yachts UR - http://app.ntsb.gov/doclib/reports/2004/MAB0401.pdf UR - https://trid.trb.org/view/759267 ER - TY - RPRT AN - 00975884 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-8 THROUGH -14 PY - 2004/04/21 SP - 11 p. AB - These safety recommendations, addressed to State and District of Columbia child care transportation oversight agencies (a distribution list is provided), are derived from the National Transportation Safety Board's investigation of an April 4, 2002, accident involving a child care van in Memphis, Tennessee, and are consistent with the evidence found and analysis performed. The Safety Board recommends that the State and District of Columbia child care transportation oversight agencies implement an oversight program for child care transportation that includes the following elements: Use of vehicles built to school bus standards or of multifunction school activity buses (H-04-8); A regular vehicle maintenance and inspection program (H-04-9); A requirement that occupants wear age-appropriate restraints at all times (H-04-10); A requirement that drivers receive a criminal background check and have a medical examination to determine fitness to drive (H-04-11); Preemployment, random, postaccident, and "for cause" drug testing for all child care transportation providers and the prohibition of anyone who tests positive for drugs from transporting children (H-04-12); Review by an oversight agency of periodic driver background checks, medical examinations, and drug test results (H-04-13); and A requirement that child care vehicles be labeled with the child care center's and oversight agency's names and phone numbers (H-04-14). KW - Child care centers KW - Child care transportation KW - Children KW - Crash investigation KW - Criminal histories KW - Design standards KW - Drivers KW - Drug tests KW - Inspection KW - Medical examinations and tests KW - Oversight KW - Oversight agencies KW - Ran off road crashes KW - Recommendations KW - Restraint systems KW - Small buses KW - Traffic crashes KW - Transportation safety KW - Vans KW - Vehicle maintenance KW - Vehicle marking KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H04_18_20.pdf UR - https://trid.trb.org/view/702665 ER - TY - RPRT AN - 00974047 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT BRIEF: LOSS OF CONTROL AND IMPACT WITH TERRAIN, CANADAIR CHALLENGER CL-604 FLIGHT TEST AIRPLANE, C-FTBZ, WICHITA, KANSAS, OCTOBER 10, 2000 PY - 2004/04/14 SP - 32 p. AB - On October 10, 2000, at 2:52 p.m., a Canadair Challenger CL-600-2B16 was destroyed on impact with terrain and postimpact fire during initial climb from a runway at Wichita Mid-Continent Airport in Wichita, Kansas. The flight was operating as an experimental test flight. The pilot and flight test engineer were killed. The copilot was seriously injured and died 36 days later. The National Transportation Safety Board determined that the probable cause of this accident was the pilot's excessive takeoff rotation, during an aft center of gravity (c.g.) takeoff, a rearward migration of fuel during acceleration and takeoff and consequent shift in the airplane's aft c.g. to aft of the left c.g. limit, which caused the airplane to stall at an altitude too low for recovery. Contributing to the accident were inadequate flight planning procedures for the flight test program and the lack of direct, on-site operational oversight by Transport Canada and the Federal Aviation Administration. KW - Acceleration (Mechanics) KW - Air pilots KW - Air transportation crashes KW - Center of gravity KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Flight plans KW - Flight tests KW - Oversight KW - Stall KW - Takeoff KW - Transport Canada KW - U.S. Federal Aviation Administration KW - U.S. National Transportation Safety Board KW - Wichita (Kansas) UR - https://www.ntsb.gov/doclib/reports/2004/AAB0401.pdf UR - https://trid.trb.org/view/697837 ER - TY - RPRT AN - 00974053 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: DERAILMENT OF RUNAWAY RAILCARS ON UNION PACIFIC RAILROAD, CITY OF COMMERCE, CALIFORNIA, JUNE 20, 2003 PY - 2004/04/07 SP - 8 p. AB - In the late morning of June 20, 2003, a string of 31 freight cars that had been part of a Union Pacific Railroad (UP) freight train were cut from their locomotives at a UP siding in Montclair, California. After crewmembers released the cars' air brakes in preparation for switching the cars in Montclair yard, the cars began rolling. The runaway cars rolled downgrade for about 28 miles and reached a calculated maximum speed of 95 mph before derailing in City of Commerce, California, at 11:58 a.m. Some of the derailed cars struck nearby residences. Three residences were destroyed, and five others were damaged. Thirteen people suffered minor injuries. About 150 people were evacuated from the area because of broken natural gas and water lines. Estimated damages were $2.4 million. The National Transportation Safety Board determines that the probable cause of the derailment of the runaway cars was the failure of both the inbound train crew and the switching crew to properly secure the railcars as required by Union Pacific operating rules before the airbrakes were released on the cars. Contributing to the accident was the failure of the Union Pacific Railroad to enforce the application of its operating rules for securing freight equipment before locomotives are uncoupled. KW - Air brakes KW - California KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Freight cars KW - Railroad crashes KW - Switching KW - Train crews KW - Train operations KW - U.S. National Transportation Safety Board KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0403.pdf UR - https://trid.trb.org/view/697843 ER - TY - RPRT AN - 00974045 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: 15-PASSENGER CHILD CARE VAN RUN-OFF-ROAD ACCIDENT, MEMPHIS, TENNESSEE, APRIL 4, 2002 PY - 2004/04/07 SP - 64 p. AB - On April 4, 2002, about 8:19 a.m., a 15-passenger van transporting six children to school was southbound in the left lane of Interstate 240 in Memphis, Tennessee. The van was owned and operated by a private child care center. The vehicle was traveling about 65 mph when it drifted from the left lane, across two other lanes, and off the right side of the roadway. The van then overrode the guardrail and continued to travel along the embankment until the front of the van collided with the back of the guardrail and a light pole. The rear of the van rotated counterclockwise and the front and right side of the van struck the bridge abutment at an overpass before coming to rest. The driver was ejected through the windshield and sustained fatal injuries. Four of the children sustained fatal injuries, and two were seriously injured. The Safety Board determines that the probable cause of this accident was the absence of oversight by the child care center and the driver's inability to maintain control of his vehicle because he fell asleep. Contributing to the accident was the Tennessee Department of Human Services lack of oversight of child care transportation. Contributing to the severity of the injuries were the use of a 15-passenger van to transport pupils, the nonuse of appropriate restraints, and the design of the roadside barrier system. The major safety issues discussed in this report are child care transportation oversight and highway barrier design. As a result of this investigation, the Safety Board makes recommendations to state child care transportation oversight agencies, the State Departments of Transportation, the National Association for the Education of Young Children, and the American Association of State Highway and Transportation Officials. KW - Barriers (Roads) KW - Crash analysis KW - Crash causes KW - Crash characteristics KW - Crash injuries KW - Crash injury research KW - Crash investigation KW - Crash reconstruction KW - Day care centers KW - Drivers KW - Fatalities KW - Government agencies KW - Oversight KW - Ran off road crashes KW - Restraint systems KW - School children KW - Survival KW - Traffic crash victims KW - Traffic crashes KW - U.S. National Transportation Safety Board KW - Vans UR - http://app.ntsb.gov/doclib/reports/2004/HAR0402.pdf UR - https://trid.trb.org/view/697835 ER - TY - RPRT AN - 01014955 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Excavation Damage to Natural Gas Distribution Line Resulting in Explosion and Fire, Wilmington, Delaware, July 2, 2003 PY - 2004/04/06 SP - 7p AB - On July 2, 2003, a contractor hired by the city of Wilmington, Delaware, to replace sidewalk and curbing dug into an unmarked natural gas service line with a backhoe. Although the service line did not leak where it was struck, the contact resulted in a break in the line inside the basement of 1816 West 3rd Street, where gas began to accumulate. A manager for the contractor said that he did not smell gas and therefore did not believe there was imminent danger and that he called an employee of the gas company and left a voice mail message. At approximately 1:44 p.m., an explosion destroyed two residences and damaged two others to the extent that they had to be demolished. Other nearby residences sustained some damage, and the residents on the block were displaced from their homes for about a week. Three contractor employees sustained serious injuries. Eleven additional people sustained minor injuries. The National Transportation Safety Board determines that the probable cause of the July 2, 2003, natural gas explosion in Wilmington, Delaware, was the failure of Quickform to verify that all underground facilities were marked within the proposed dig site before beginning excavation. Contributing to the accident was the failure of Tech Consultants and Quickform to effectively communicate about the project scope. Also contributing to the severity of the accident was the failure of Quickform employees to immediately notify the utility owner and emergency authorities when they realized they had struck and pulled up a gas service line. KW - Backhoes KW - Communication KW - Disaster preparedness KW - Excavation KW - Explosions KW - Fire KW - Injuries KW - Labeling KW - Labeling (Marking utility components) KW - Leakage KW - Natural gas distribution systems KW - Natural gas pipelines KW - Pipeline accidents KW - Pipeline safety KW - Rupture KW - Wilmington (Delaware) UR - http://app.ntsb.gov/doclib/reports/2004/PAB0401.pdf UR - https://trid.trb.org/view/771517 ER - TY - RPRT AN - 00975840 AU - National Transportation Safety Board TI - MARINE ACCIDENT REPORT: SINKING OF THE U.S. SMALL PASSENGER VESSEL "PANTHER" NEAR EVERGLADES CITY, FLORIDA, DECEMBER 30, 2002 PY - 2004/03/09 SP - 53 p. AB - This report discusses the sinking of the U.S. small passenger vessel "Panther" in the Ten Thousand Islands area of Everglades National Park, Florida, on December 30, 2002. The accident resulted in no deaths and one serious injury. Damage to the Panther was estimated at $60,000. From its investigation of the accident, the National Transportation Safety Board identified the following safety issues: company operations, company's preventive maintenance program, and lifejacket stowage. On the basis of its findings, the Safety Board made recommendations to the National Park Service. KW - Crash causes KW - Everglades National Park KW - Injuries KW - Lifejacket stowage KW - Loss and damage KW - National Park Service KW - Operations KW - Passenger ships KW - Preventive maintenance KW - Small passenger vessels KW - Ten Thousand Islands (Florida) KW - Water transportation crashes UR - http://www.offshoreblue.com/assets/resources/safety/accidents/panther.pdf UR - https://trid.trb.org/view/702623 ER - TY - RPRT AN - 00974054 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: DERAILMENT OF CANADIAN PACIFIC RAILWAY FRIEGHT TRAIN 292-16 AND SUBSEQUENT RELEASE OF ANHYDROUS AMMONIA NEAR MINOT, NORTH DAKOTA, JANUARY 18, 2002 PY - 2004/03/09 SP - 92 p. AB - At approximately 1:37 a.m. on January 18, 2002, an eastbound Canadian Pacific Railway freight train, traveling about 41 mph, derailed 31 of its 112 cars near Minot, North Dakota. Five tank cars carrying anhydrous ammonia, a liquefied compressed gas, catastrophically ruptured, and a vapor plume covered the derailment site and surrounding area. About 11,600 people occupying the area were affected by the vapor plume. As a result of the accident, one resident was fatally injured, 11 people sustained serious injuries, and 322 people, including the 2 train crewmembers, sustained minor injuries. Damages exceeded $2 million, and more than $8 million has been spent for environmental remediation. The National Transportation Safety Board determines that the probable cause of the derailment was an ineffective inspection and maintenance program that did not identify and replace cracked joint bars before they completely fractured and led to the breaking of the rail at the joint. Contributing to the severity of the accident was the catastrophic failure of five tank cars and the instantaneous release of about 146,700 gallons of anhydrous ammonia. The safety issues identified in this accident were: (1) Canadian Pacific Railway's programs and practices for the inspection and maintenance of joint bars in its continuous welded rail; (2) the Federal Railroad Administration's oversight of continuous welded rail maintenance programs; and (3) tank car crashworthiness. The analysis also addresses the appropriateness of using shelter-in-place to protect the public from the release of hazardous material. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Federal Railroad Administration and the Canadian Pacific Railway. KW - Ammonia KW - Canadian Pacific KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crashworthiness KW - Derailments KW - Disasters and emergency operations KW - Fracture mechanics KW - Hazardous chemicals KW - Injuries KW - Inspection KW - Maintenance practices KW - North Dakota KW - Oversight KW - Poisonous gases KW - Railroad crashes KW - Railroad safety KW - Tank cars KW - Tie bars KW - U.S. Federal Railroad Administration KW - U.S. National Transportation Safety Board KW - Vapors UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0401.pdf UR - https://trid.trb.org/view/697844 ER - TY - RPRT AN - 00974048 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: LOSS OF PITCH CONTROL DURING TAKEOFF, AIR MIDWEST FLIGHT 5481, RAYTHEON (BEECHCRAFT) 1900D, N233YV, CHARLOTTE, NORTH CAROLINA, JANUARY 8, 2003 PY - 2004/02/26 SP - 216 p. AB - On January 8, 2003, about 8:47 a.m., Air Midwest flight 5481, a Raytheon (Beechcraft) 1900D, N233YV, crashed shortly after takeoff from a runway at Charlotte-Douglas International Airport, Charlotte, North Carolina. The 2 flight crewmembers and 19 passengers aboard the airplane were killed, 1 person on the ground received minor injuries, and the airplane was destroyed by impact forces and a postcrash fire. Flight 5481 was a regularly scheduled passenger flight. The National Transportation Safety Board determines that the probable cause of this accident was the airplane's loss of pitch control during takeoff. The loss of pitch control resulted from the incorrect rigging of the elevator control system compounded by the airplane's aft center of gravity, which was substantially aft of the certified aft limit. Contributing to the cause of the accident were Air Midwest's lack of oversight of the work being performed at a maintenance station; Air Midwest's maintenance procedures and documentation; Air Midwest's weight and balance program at the time of the accident; the Raytheon Aerospace quality assurance inspector's failure to detect the incorrect rigging of the elevator control system; the Federal Aviation Administration's (FAA) average weight assumptions in its weight and balance program guidance at the time of the accident; and the FAA's lack of oversight of Air Midwest's maintenance program and its weight and balance program. The safety issues in this report focus on maintenance work practices, oversight, and quality assurance; aircraft weight and balance programs; maintenance training; FAA oversight; and Beech 1900 cockpit voice recorder problems. Safety recommendations concerning these issues are addressed to the FAA. KW - Air Midwest KW - Air transportation crashes KW - Aviation safety KW - Balance KW - Center of gravity KW - Charlotte (North Carolina) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Elevator control system KW - Loss of control KW - Maintenance practices KW - Oversight KW - Passenger aircraft KW - Pitch (Dynamics) KW - Quality assurance KW - Takeoff KW - U.S. Federal Aviation Administration KW - U.S. National Transportation Safety Board KW - Weight UR - https://www.ntsb.gov/doclib/reports/2004/AAR0401.pdf UR - https://trid.trb.org/view/697838 ER - TY - RPRT AN - 00975866 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-01 THROUGH -03 PY - 2004/02/23 SP - 5 p. AB - This safety recommendation, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration, recommends that the Federal Highway Administration: Incorporate into the "Manual on Uniform Traffic Control Devices" the stricter criteria on work zone safety and management contained in the "Federal-Aid Policy Guide, 23 Code of Federal Regulations 630J, Subchapter G-Engineering and Traffic Operations, Part 630-Preconstruction Procedures, Subpart J-Traffic Safety in Highway and Street Work Zones," to include continuously monitoring traffic accident experience in work zones to detect and correct safety deficiencies existing in individual projects. Further, the traffic accident reports necessary to accomplish this should be obtained monthly, directly from local traffic law enforcement agencies (H-04-01); Require divisional offices to participate in the States' work zone safety inspections and diligently monitor and evaluate the results of those inspections in conformance with the "Federal-Aid Policy Guide, 23 Code of Federal Regulations 630J, Subchapter G-Engineering and Traffic Operations, Part 630-Preconstruction Procedures, Subpart J-Traffic Safety in Highway and Street Work Zones" (H-04-02); and Include in the "Manual on Uniform Traffic Control Devices" a requirement that, for roadways under construction, traffic safety features (such as barrier systems) be maintained at an equivalent or better level than existed prior to construction (H-04-03). These recommendations result from the investigation of a bus accident in a work zone that resulted in four fatalities and injuries to the bus driver and remaining passengers ranging from serious to minor. KW - Bus crashes KW - Crash investigation KW - Improvements KW - Inspection KW - Manual on Uniform Traffic Control Devices KW - Monitoring KW - Recommendations KW - Safety management KW - Traffic safety KW - Work zone safety KW - Work zone traffic control UR - https://trid.trb.org/view/702647 ER - TY - RPRT AN - 00975867 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-04 PY - 2004/02/23 SP - 4 p. AB - This safety recommendation, addressed to Mr. John L. Craig, Director, Nebraska Department of Roads, addresses work zone safety and management. This recommendation results from the investigation of a bus accident in a work zone that resulted in four fatalities and injuries to the bus driver and remaining passengers ranging from serious to minor. The National Transportation Safety Board recommends that the Nebraska Department of Roads initiate a program to obtain work zone traffic accident reports from law enforcement agencies monthly and analyze these data to aid in identifying and eliminating hazards as they develop. KW - Bus crashes KW - Crash investigation KW - Crash reports KW - Hazard analysis KW - Nebraska Department of Roads KW - Recommendations KW - Reviews KW - Safety management KW - State departments of transportation KW - Work zone safety KW - Work zone traffic control UR - https://trid.trb.org/view/702648 ER - TY - RPRT AN - 00975870 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-07 PY - 2004/02/23 SP - 2 p. AB - This safety recommendation, addressed to Mr. John O'Leary, President, Thomas Built Buses, Inc., addresses luggage racks in school buses potentially blocking emergency signage. This recommendation results from the investigation of a bus accident in a work zone that resulted in four fatalities and injuries to the bus driver and remaining passengers ranging from serious to minor. The National Transportation Safety Board recommends that Thomas Built Buses, Inc., ensure that all emergency signage is visible in school buses equipped with overhead luggage racks. KW - Bus crashes KW - Crash investigation KW - Emergency exits KW - Recommendations KW - School buses KW - Signs KW - Thomas Built Buses, Incorporated KW - Vehicle safety KW - Visibility KW - Work zones UR - https://trid.trb.org/view/702651 ER - TY - RPRT AN - 00975868 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-05 PY - 2004/02/23 SP - 3 p. AB - This safety recommendation, addressed to Mr. Rob Dahlquist, Fire Chief, Omaha Fire Department, addresses school bus extrication training. This recommendation results from the investigation of a bus accident in a work zone that resulted in four fatalities and injuries to the bus driver and remaining passengers ranging from serious to minor. The National Transportation Safety Board recommends that the Omaha Fire Department provide emergency responders with school bus extrication training. KW - Bus crashes KW - Crash investigation KW - Emergency extrication KW - Emergency training KW - Fire departments KW - Recommendations KW - School buses KW - Work zones UR - https://trid.trb.org/view/702649 ER - TY - RPRT AN - 00975869 AU - Conners, E E AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-04-06 PY - 2004/02/23 SP - 3 p. AB - This safety recommendation, addressed to Mr. Charlie Gauthier, Executive Director, National Association of State Directors of Pupil Transportation Services, addresses pretrip briefings and emergency evacuation training. This recommendation results from the investigation of a bus accident in a work zone that resulted in four fatalities and injuries to the bus driver and remaining passengers ranging from serious to minor. The National Transportation Safety Board recommends that the National Association of State Directors of Pupil Transportation Services prepare a report that can be used by the State Directors to influence their States to require pretrip briefings before school-related activity trips on school buses or school-chartered buses and subsequently assist the States in developing criteria for such briefings, to include training all students regarding the location and use of emergency exits. KW - Bus crashes KW - Crash investigation KW - Emergency exits KW - Evacuation KW - National Assoc of State Directors of Pupil Transportation KW - Pretrip briefings KW - Recommendations KW - School buses KW - School trips KW - Students KW - Training KW - Work zones UR - https://trid.trb.org/view/702650 ER - TY - RPRT AN - 00974057 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: AMTRAK TRAIN 774 STRIKING MAINTENANCE-OF-WAY WORKERS, SAN JUAN CAPISTRANO, CALIFORNIA, APRIL 1, 2003 PY - 2004/02/13 SP - 7 p. AB - About 1:38 p.m., Pacific standard time, on April 1, 2003, eastbound Amtrak train 774 struck two maintenance-of-way workers at control point Avery near San Juan Capistrano, California. Both workers were fatally injured. According to event recorder data, train speed was 90 mph. The Amtrak 774 engineer said that he sounded the horn and placed the train into emergency braking moments before impact. The fatally injured workers were part of a five-person crew employed by Herzog Contracting Corporation to provide maintenance-of-way services under a contract with the Southern California Regional Rail Authority (Metrolink). The accident occurred on tracks owned by the Orange County Transportation Authority and operated by Metrolink. The National Transportation Safety Board determines that the probable cause of the accident was the inattentiveness of the assigned lookout as well as his failure to comply with applicable rules by posting advance lookouts or requesting another means of protection from train movements. Also contributing to the accident was the ineffectiveness of the Metrolink and Herzog efficiency test programs with regard to on-track safety procedure compliance. KW - Attention lapses KW - California KW - Compliance KW - Contractors KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Fatalities KW - Herzog Contracting Corporation KW - Maintenance personnel KW - Railroad crashes KW - Railroad safety KW - Southern California Regional Rail Authority KW - U.S. National Transportation Safety Board KW - Work zone safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0401.pdf UR - https://trid.trb.org/view/697847 ER - TY - RPRT AN - 00974056 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: COLLISION OF BURLINGTON NORTHERN SANTA FE RAILWAY IN SCOTTSBLUFF, NEBRASKA, FEBRUARY 13, 2003 PY - 2004/02/13 SP - 5 p. AB - On February 13, 2003, about 12:25 p.m., an eastbound Burlington Northern Santa Fe Railway (BNSF) unit coal train collided with a BNSF yard train on the main track in Scottsbluff, Nebraska. The coal train consisted of 2 locomotives and 124 loaded cars; the yard train consisted of 1 locomotive and 16 freight cars. Both locomotives of the coal train and 28 cars of coal derailed; the locomotive and 3 cars of the yard train derailed. The crew of the coal train consisted of an engineer and a conductor. The engineer received minor injuries, and the conductor sustained fatal injuries. The crew of the yard train consisted of an engineer, a conductor, and a brakeman. The yard train engineer received minor injuries. The National Transportation Safety Board determines that the probable cause of the collision was the failure of the yard train's conductor to properly line and lock the switches for the yard train's intended route. Contributing to the cause of the accident was the lack of an electronic connection between the inner switch and main track signal system. KW - BNSF Railway KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Fatalities KW - Freight trains KW - Hopper cars KW - Injuries KW - Railroad crashes KW - Switching KW - U.S. National Transportation Safety Board KW - Yard operations UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB0402.pdf UR - https://trid.trb.org/view/697846 ER - TY - RPRT AN - 00974046 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: SCHOOL BUS RUN-OFF-BRIDGE ACCIDENT, OMAHA, NEBRASKA, OCTOBER 13, 2001 PY - 2004/02/10 SP - 98 p. AB - On October 13, 2001, about 2:00 p.m., a 78-passenger school bus carrying 27 high school students and 3 adults (as well as the driver) was traveling westbound through a work zone on U.S. Route 6 in Omaha, Nebraska. As the school bus entered the work zone lane shift at a bridge approach, it encountered a motorcoach traveling eastbound. Although no collision occurred between the two buses, the westbound school bus departed the traveled roadway on the right, struck the W-beam barrier on the approach to the bridge twice, and struck a three-rail barrier between the guardrail and the concrete bridge railing. The bus passed through the remains of the three-rail barrier, rode up onto the bridge's sidewall, and rolled 270 degrees clockwise as it fell about 49 feet. Three students and one adult sustained fatal injuries. The remaining passengers and the bus driver sustained injuries ranging from serious to minor. The National Transportation Safety Board determines that the probable cause of this accident was the failure of the Nebraska Department of Roads to recognize and correct the hazardous condition in the work zone created by the irregular geometry of the roadway, the narrow lane widths, and the speed limit. Contributing to the accident was the bus driver's inability to maintain the bus within the lane due to the perceived or actual threat of a frontal collision with the approaching eastbound motorcoach and the accident bus driver's unfamiliarity with the accident vehicle. Contributing to the severity of the accident was the failure of the traffic barrier system to redirect the accident vehicle. Major safety issues identified in this accident include: (1) effect of highway design, speed, and vehicle handling characteristics upon driver performance: (2) adequacy of work zone safety management; (3) lack of emergency preparedness of students; (4) visibility of emergency signage and exit door levers; and (5) school bus extrication training. As a result of this accident investigation, the National Transportation Safety Board makes recommendations to the Federal Highway Administration, Nebraska Department of Roads, Omaha Fire Department, National Association of State Directors of Pupil Transportation Services, and Thomas Built Buses, Inc. KW - Barriers (Roads) KW - Crash analysis KW - Crash causes KW - Crash characteristics KW - Crash injuries KW - Crash investigation KW - Emergency exits KW - Emergency training KW - Fatalities KW - Highway bridges KW - Highway departments KW - Highway design KW - Omaha (Nebraska) KW - Ran off road crashes KW - School bus drivers KW - School buses KW - Traffic crash victims KW - Traffic crashes KW - U.S. National Transportation Safety Board KW - Work zone safety KW - Work zone traffic control UR - http://app.ntsb.gov/doclib/reports/2004/HAR0401.pdf UR - https://trid.trb.org/view/697836 ER - TY - RPRT AN - 00974055 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: CHICAGO TRANSIT AUTHORITHY GREEN LINE TRAIN RUN 2, TRAIN/WORKER INCIDENT AT TOWER 18, CHICAGO, ILLINOIS, FEBRUARY 26, 2002 PY - 2004/02/06 SP - 4 p. AB - On Tuesday, February 26, 2002, at approximately 4:50 a.m., a Chicago Transit Authority train struck two signal maintainers who were working near tower 18, which is on a section of the Chicago Loop. The Loop is elevated, and one maintainer fell from the structure, landed on a parked car and then the street and was seriously injured. At the time of the accident, it was dark, the skies were cloudy, snow was falling lightly, and the temperature was 36 deg F. The National Transportation Safety Board determines that the probable cause of the accident was the failure of the signal maintainers to watch for approaching trains and their failure to obey the Chicago Transit Authority's requirement that they increase their visibility by displaying a flashing yellow warning light. Contributing to the maintainers' reduced awareness of oncoming trains was the absence of clear requirements regarding the designation of safety lookouts and the use of interlocking signals to protect work areas. KW - Awareness KW - Chicago (Illinois) KW - Chicago Transit Authority KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Elevated guideways KW - Human factors in crashes KW - Injuries KW - Occupational safety KW - Railroad crashes KW - Railroad safety KW - Signal maintainers KW - U.S. National Transportation Safety Board KW - Visibility KW - Warning signals KW - Work zone safety UR - https://www.ntsb.gov/doclib/reports/2003/RAB0304.pdf UR - https://trid.trb.org/view/697845 ER - TY - RPRT AN - 00984860 AU - National Transportation Safety Board TI - HIGHWAY/MARINE ACCIDENT REPORT: U.S. TOWBOAT ROBERT Y. LOVE ALLISION WITH INTERSTATE 40 HIGHWAY BRIDGE NEAR WEBBERS FALLS, OKLAHOMA, MAY 26, 2002 PY - 2004 SP - 90 p. AB - About 0745, on May 26, 2002, the towboat Robert Y. Love, pushing two empty asphalt tank barges, was traveling northbound on the McClellan-Kerr Arkansas River Navigation System, near Webbers Falls, Oklahoma. As the tow approached the Interstate 40 highway bridge at mile 360.3, it veered off course and rammed a pier 201 feet west of (outside) the navigation channel. The impact collapsed a 503-foot section of the bridge, which fell into the river and on to the barges below. According to witnesses, highway traffic continued to drive into the void the bridge created by the collapsed spans. When traffic stopped, eight passenger vehicles and three truck tractor-semitrailer combinations had fallen into the river or onto the collapsed portions of the bridge. The accident resulted in 14 fatalities and 5 injuries and caused an estimated $30.1 million in damage to the bridge, including the operation of detours, and $276,000 in damage to the barges. The major safety issues discussed in this report include the captain's incapacitation and countermeasures for such an event; bridge protection, including risk assessment; and mitigation of loss of life, including motorist warning systems. As a result of this accident, the National Transportation Safety Board makes recommendations to the U.S. Coast Guard, the Federal Highway Administration, and the American Association of State Highway and Transportation Officials. KW - Allisions KW - American Association of State Highway and Transportation Officials KW - Bridge piers KW - Collapse KW - Countermeasures KW - Fatalities KW - Highway bridges KW - Highway safety KW - Injuries KW - Interstate highways KW - Marine safety KW - Oklahoma KW - Passenger vehicles KW - Protection KW - Recommendations KW - Risk assessment KW - Rivers KW - Ship pilotage KW - Ship pilots KW - Tank barges KW - Towboats KW - Tractor trailer combinations KW - Traffic crashes KW - U.S. Federal Highway Administration KW - United States Coast Guard KW - Warning systems KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/2004/HAR0405.pdf UR - https://trid.trb.org/view/745799 ER - TY - RPRT AN - 00975857 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-30 AND -31 PY - 2003/12/16 SP - 4 p. AB - These two safety recommendations, addressed to Mr. Robert M. Garrett, Executive Secretary, National Committee on Uniform Traffic Control Devices, address the use of all-red-flash railroad hold intervals at signalized highway-rail grade crossings and adherence to, as well as the ready availability of, applicable engineering guidance in designing traffic signals and other safety features at grade crossings. The National Transportation Safety Board recommends that the National Committee on Uniform Traffic Control Devices: Limit the use of highway traffic signals in the all-red-flash mode to situations in which they permit motorists to stop and proceed with caution (H-03-30); and Incorporate into chapter 1 of the "Manual on Uniform Traffic Control Devices," at the time of each update, a list of references, including Internet Web sites, for traffic and safety engineering design guidelines (H-03-31). KW - Flashing traffic signals KW - Guidelines KW - Guides to the literature KW - Highway safety KW - Manual on Uniform Traffic Control Devices KW - Railroad grade crossings KW - Recommendations KW - Traffic crashes KW - Websites (Information retrieval) UR - https://trid.trb.org/view/702637 ER - TY - RPRT AN - 00975854 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-28 PY - 2003/12/16 SP - 3 p. AB - This safety recommendation, addressed to the Honorable Stacey Murphy, Mayor, City of Burbank, addresses the need for additional safety features at the North San Fernando Boulevard-North Buena Vista Street grade crossing. It is recommended that the City of Burbank, California, install a raised median or other barrier system at the North San Fernando Boulevard-North Buena Vista Street grade crossing that extends from the crossing to the end of the double yellow centerlines south of the tracks. KW - Barriers (Roads) KW - Countermeasures KW - Highway safety KW - Railroad grade crossings KW - Raised medians KW - Recommendations KW - Traffic crashes UR - https://trid.trb.org/view/702634 ER - TY - RPRT AN - 00975856 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-30 PY - 2003/12/16 SP - 3 p. AB - This safety recommendation, addressed to Ms. Leila Osina, Executive Director, National Committee on Uniform Traffic Laws and Ordinances, addresses the use of all-red flash railroad hold internals at signalized highway-rail grade crossings. The Safety Board concluded that use of the all-red-flash mode for traffic signals at a railroad grade crossing has ambiguous meaning, can be confusing to motorists, and, as a result, creates unnecessary risks to life and property. It is recommended that the National Committee on Uniform Traffic Laws and Ordinances limit the use of highway traffic signals in the all-red-flash mode to situations in which they permit motorists to stop and proceed with caution. KW - Flashing traffic signals KW - Highway safety KW - Railroad grade crossings KW - Recommendations KW - Traffic crashes UR - https://trid.trb.org/view/702636 ER - TY - RPRT AN - 00975858 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-32 PY - 2003/12/16 SP - 3 p. AB - This safety recommendation, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration; Mr. John Horsley, Executive Director, American Association of State Highway and Transportation Officials; Mr. Thomas W. Brahms, Executive Director, Institute of Transportation Engineers; and Mr. Robert E. Skinner, Jr., Executive Director, Transportation Research Board, addresses the ready availability of applicable engineering guidance in designing traffic signals and other safety features at grade crossings. The National Transportation Safety Board concluded that current information and guidelines for designing safe highway-rail grade crossings and traffic signals are available but can be difficult to find and expensive to obtain. The Safety Board recommends that the Federal Highway Administration, the American Association of State Highway and Transportation Officials, the Institute of Transportation Engineers, and the Transportation Research Board improve the ease with which transportation and civil engineers can locate and obtain safety design guidelines and related information on Internet Web sites, as well as through other means, and make available to governmental entities a no-cost option for obtaining critical safety design guidelines. KW - Guidelines KW - Guides to information KW - Highway safety KW - Railroad grade crossings KW - Recommendations KW - Traffic crashes KW - Traffic signals KW - Websites (Information retrieval) UR - https://trid.trb.org/view/702638 ER - TY - RPRT AN - 00975855 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-29 PY - 2003/12/16 SP - 3 p. AB - This safety recommendation, addressed to Mr. Jeff P. Morales, Director, California Department of Transportation, addresses the use of all-red-flash railroad hold intervals at signalized highway-rail grade crossings. The Safety Board concluded that use of the all-red-flash mode for traffic signals at a railroad grade crossing has ambiguous meaning, can be confusing to motorists, and, as a result, creates unnecessary risks to life and property. It is recommended that the California Department of Transportation prohibit the all-red-flash option for traffic signal indications during the railroad hold interval at grade crossings. KW - Flashing traffic signals KW - Highway safety KW - Railroad grade crossings KW - Recommendations KW - Traffic crashes UR - https://trid.trb.org/view/702635 ER - TY - RPRT AN - 00970584 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION BETWEEN METROLINK TRAIN 210 AND FORD CREW CAB, STAKE BED TRUCK AT HIGHWAY-RAIL GRADE CROSSING, BURBANK, CALIFORNIA, JANUARY 6, 2003 PY - 2003/12/02 SP - 44 p. AB - On January 6, 2003, Metrolink commuter train 210 struck a Ford F-550 crew cab, stake bed truck at a grade crossing in Burbank, California. Upon impact, the truck's cab moved with the train, until the train derailed about 1,300 ft from the crossing. The truck driver was fatally injured. Of the train's 59 passengers and 2 crew members, 32 sustained injuries; 1 passenger died 15 days later from internal injuries that were probably sustained during the accident. The major safety issues discussed in this report are the use of "all-red-flash" railroad hold intervals at signalized highway-rail grade crossings and adherence to applicable engineering guidance in designing traffic signals and other safety features at grade crossings. As a result of its investigation, the Safety Board makes recommendations to the Federal Highway Administration; the California Department of Transportation; the city of Burbank, California; the American Association of State Highway and Transportation Officials; the Institute of Transportation Engineers; the National Committee on Uniform Traffic Control Devices; the National Committee on Uniform Traffic Laws and Ordinances; and the Transportation Research Board. KW - Crash reports KW - Fatalities KW - Flashing traffic signals KW - Injuries KW - Railroad commuter service KW - Railroad grade crossings KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0304.pdf UR - https://trid.trb.org/view/696556 ER - TY - RPRT AN - 00974059 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: HEAD-ON COLLISION, NORTHEAST ILLINOIS REGIONAL COMMUTER RAILROAD CORPORATION, AURORA, ILLINOIS, JUNE 12, 2002 PY - 2003/11/24 SP - 3 p. AB - About 3:21 p.m., central daylight time, on June 12, 2002, eastbound commuter train 1270 operating in the "push" mode collided head on with westbound commuter train 1235 operating in the "pull" mode, near milepost 36.7 near Aurora, Illinois. The collision resulted in the derailment of the cab car and four passenger cars of train 1270 and the locomotive and three passenger cars of train 1235. Two crewmembers and 3 passengers on train 1270 and 3 crewmembers and 39 passengers on train 1235 were injured. The commuter trains were operating on the Aurora Subdivision of the Burlington Northern Santa Fe Railway (BNSF) and were owned by the Northeast Illinois Regional Commuter Railroad Corporation (Metra). Total damages estimated by the railroads exceeded $292,000. The National Transportation Safety Board determines that the probable cause of the head-on collision was the failure of the engineer and the conductor of train 1270 to comply with the stop signal at the Aurora Transportation Center Station. KW - Crash analysis KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Frontal crashes KW - Illinois KW - Railroad commuter service KW - Railroad crashes KW - Railroad signals KW - U.S. National Transportation Safety Board UR - https://www.ntsb.gov/doclib/reports/2003/RAB0308.pdf UR - https://trid.trb.org/view/697849 ER - TY - RPRT AN - 00974049 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: LOSS OF CONTROL AND IMPACT WITH TERRAIN, AVIATION CHARTER, INC. RAYTHEON (BEECHCRAFT) KING AIR A100, N41BE, EVELETH, MINNESOTA, OCTOBER 25, 2002 PY - 2003/11/18 SP - 76 p. AB - On October 25, 2002, about 10:22 a.m., a Raytheon (Beechcraft) King Air A100, N41BE, operated by Aviation Charter, Inc., crashed while the flight crew was attempting to execute the visual operating rules approach to runway 27 at Eveleth-Virginia Municipal Airport, Eveleth, Minnesota. The crash site was located about 1.8 nautical miles southeast of the approach end of runway 27. The two pilots and six passengers were killed, and the airplane was destroyed by impact forces and a postcrash fire. The airplane was being operated under the provisions of 14 Code of Federal Regulations Part 135 as an on-demand passenger charter flight. Instrument meteorological conditions prevailed for the flight, which operated on an instrument flight rules flight plan. The National Transportation Safety Board determines that the probable cause of this accident was the flight crew's failure to maintain adequate airspeed, which led to an aerodynamic stall from which they did not recover. The safety issues discussed in this report include flight crew proficiency, Aviation Charter operational and training issues, inadequate crew resource management (CRM) training, Federal Aviation Administration (FAA) surveillance, and the need for improved low-airspeed awareness. Safety recommendations concerning CRM training, FAA surveillance, and low-airspeed alert systems are addressed to the FAA. KW - Air transportation crashes KW - Airspeed KW - Approach control KW - Aviation safety KW - Cockpit resource management KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Flight crews KW - Landing KW - Minnesota KW - Oversight KW - Stall KW - Training KW - U.S. Federal Aviation Administration KW - U.S. National Transportation Safety Board UR - https://www.ntsb.gov/doclib/reports/2003/AAR0303.pdf UR - https://trid.trb.org/view/697839 ER - TY - RPRT AN - 00974060 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: HIGHWAY/RAILROAD GRADE CROSSING COLLISION, CANADIAN NATIONAL/ILLINOIS CENTRAL RAILROAD, PORT HUDSON, LOUISIANA, JUNE 26, 2000 PY - 2003/10/16 SP - 6 p. AB - On June 26, 2000, about 10:42 a.m., a loaded southbound tractor-semitrailer combination truck struck the lead locomotive of Canadian National/Illinois Central Railroad (CN/IC) train LBRZE-26 at the highway/rail grade crossing at the intersection of U.S. Highway 61 and the CN/IC Zee Industry Lead track near Port Hudson, Louisiana. The engineer was fatally injured, the conductor and truck driver were seriously injured, and the brakeman sustained minor injuries. The driver and four occupants of a car that had left the highway to avoid colliding with the train also sustained minor injuries. The National Transportation Safety Board determines that the probable cause of this accident was the inability of the tractor semi-trailer driver to stop his vehicle after seeing the train in time to avoid the collision. Although the grade crossing had limited visibility for identifying an approaching train, it was equipped with flashing warning lights; however, there was insufficient evidence to determine if the warning lights were functioning immediately before the collision. KW - Canadian National KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crashes KW - Fatalities KW - Grade crossing protection systems KW - Illinois Central Gulf Railroad KW - Injuries KW - Louisiana KW - Railroad crashes KW - Railroad grade crossings KW - Tractor trailer combinations KW - Truck crashes KW - U.S. National Transportation Safety Board KW - Visibility KW - Warning signals UR - https://www.ntsb.gov/doclib/reports/2003/RAB0307.pdf UR - https://trid.trb.org/view/697850 ER - TY - RPRT AN - 00974058 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION OF BURLINGTON NORTHERN SANTA FE FREIGHT TRAIN WITH METROLINK PASSENGER TRAIN, PLACENTIA, CALIFORNIA, APRIL 23, 2002 PY - 2003/10/07 SP - 50 p. AB - On Tuesday, April 23, 2002, about 8:10 a.m., eastbound Burlington Northern Santa Fe Railway freight train PLACCLO3-22 collided head on with standing westbound Southern California Regional Rail Authority passenger train 809 on the No. 2 track at Control Point Atwood in Placentia, California. A total of 162 persons were transported to local hospitals. There were two fatalities. Damage was estimated at $4.6 million. The National Transportation Safety Board determines that the probable cause of the collision was the freight train crew's inattentiveness to the signal system and their failure to observe, recognize, and act on the approach signal at milepost 42.31. Contributing to the accident was the absence of a positive train control system that would have automatically stopped the freight train short of the stop signal and thus prevented the collision. The safety issues identified during this accident investigation are as follows: (1) Burlington Northern Santa Fe train crew attentiveness; (2) Burlington Northern Santa Fe signal awareness form procedures; (3) passenger car survival factors; and (4) the absence of positive train control systems. As a result of this accident investigation, the National Transportation Safety Board makes safety recommendations to the Federal Railroad Administration, the Burlington Northern Santa Fe Railway Company, and the Association of American Railroads. The Board also reiterates a previously issued safety recommendation to the Federal Railroad Administration. KW - Attention lapses KW - Automatic train control KW - Awareness KW - BNSF Railway KW - Crash analysis KW - Crash causes KW - Crash injuries KW - Crash investigation KW - Fatalities KW - Freight trains KW - Frontal crashes KW - Injuries KW - Passenger cars KW - Passenger trains KW - Railroad crashes KW - Railroad safety KW - Railroad signals KW - Recommendations KW - Train crews KW - U.S. National Transportation Safety Board UR - http://app.ntsb.gov/doclib/reports/2003/RAR0304.pdf UR - https://trid.trb.org/view/697848 ER - TY - RPRT AN - 00974062 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: DERAILMENT OF AIRTRAIN-JFK (PORT AUTHORITY OF NEW YORK AND NEW JERSEY) (BOMBARDIER TOTAL TRANSIT SYSTEMS), JAMAICA, NEW YORK, SEPTEMBER 27, 2002 PY - 2003/09/17 SP - 6 p. AB - At about 12:25 p.m., on September 27, 2002, AirTrain-JFK light rail transit test train No. 121 derailed in a curve on the aerial guideway that runs between the Howard Beach station and the Federal Circle station near JFK International Airport in Jamaica, New York. At the time of the accident, AirTrain No. 121, with three cars and no occupants except the train operator, was participating in a power distribution system test under the authority of the transit system's testing and commissioning supervisor. When the train derailed, large concrete slabs that had been placed in the lead car for added weight shifted and pinned the train operator against the operator's console, severely injuring him. He was transported to a local hospital where he died later that day. The National Transportation Safety Board determines that the probable cause of the derailment was the failure of the train operator, for undetermined reasons, to keep his train below maximum authorized speed and to stop his train at the location specified in the design of the test in which he was participating and the failure of Bombardier Total Transit Systems to take the actions necessary to ensure that the test trains were operated in accordance with the test protocols. Contributing to the severity of the accident was the failure to properly secure the load that had been added to the first car of the accident train. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Derailments KW - Elevated guideways KW - Fatalities KW - Light rail vehicles KW - Loads KW - New York (New York) KW - Slabs KW - Speed KW - Test procedures KW - Transit crashes KW - U.S. National Transportation Safety Board KW - Weight UR - https://www.ntsb.gov/doclib/reports/2003/RAB0306.pdf UR - https://trid.trb.org/view/697852 ER - TY - RPRT AN - 01014932 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: South Charleston, West Virginia, Dana Transport, Inc., MC-307 Cargo Tank Catastrophic Structural Failure of Cargo Tank Involving 5,152 Gallons of Polypropylene Glycol, January 5, 2002 PY - 2003/08/21 SP - 8p AB - About 11:36 a.m., on January 5, 2002, a tractor/cargo tank semitrailer was leaving the Bayer Corporation’s South Charleston, West Virginia, chemical plant. (The cargo tank consisted of three independent but connected tanks.) The vehicle had stopped at a traffic signal just beyond the plant, at the intersection of Montrose Drive and MacCorkle Avenue. When the vehicle started to cross McCorkle Avenue, the cargo tank failed catastrophically between the front and center tanks and broke in two. The tanks were not breached, and no cargo was released. (The cargo tank contained 5,152 gallons of polypropylene glycol.) No one was killed, injured, or evacuated as a result of the accident. The intersection, however, was closed for 7 hours. Damage, cleanup, and lost revenues were estimated at $18,000. The National Transportation Safety Board determines that the probable cause of this accident was a combination of fatigue failure caused by incomplete welding on the tie bands and of the extensive corrosion of the frame. KW - Cargo handling KW - Catastrophic failures KW - Corrosion KW - Costs KW - Crash causes KW - Crashes KW - Fatigue (Mechanics) KW - Hazardous materials KW - Incident management KW - Intersections KW - Polypropylene glycol KW - South Charleston (West Virginia) KW - Street closure KW - Tank trucks KW - Tractor trailer combinations KW - Welding UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB0301.pdf UR - https://trid.trb.org/view/771581 ER - TY - RPRT AN - 00979280 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: METROPOLITAN ATLANTA RAPID TRANSIT AUTHORITY (MARTA) UNSCHEDULED TRAIN 166 STRIKING BUCKET OF SELF-PROPELLED LIFT CONTAINING TWO CONTRACT WORKERS AT MARTA LENOX RAIL TRANSIT STATION IN ATLANTA, GEORGIA, APRIL 10, 2000 PY - 2003/08/08 SP - 11 p. AB - About 2:30 a.m. on April 10, 2000, an unscheduled Metropolitan Atlanta Rapid Transit Authority (MARTA) train struck the bucket of a self-propelled lift that was fouling the southbound main track at MARTA's Lenox Station in Atlanta, Georgia. Two MARTA contract workers who were repairing the station ceiling occupied the bucket. Both workers received fatal injuries when they were ejected onto the station platform. Clearance procedures, single-tracking, personnel training and experience, MARTA rules compliance program, and state oversight are discussed. As a result of the accident, the Georgia Department of Transportation (GDOT) audited MARTA's operations. GDOT suggested that MARTA improve its rules testing and audit the performance and rules compliance of its employees. GDOT has accompanied MARTA managers who are doing the daily audits of employees that MARTA now requires and has determined that the audits are effective. KW - Auditing KW - Compliance KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Fatalities KW - Georgia KW - Georgia Department of Transportation KW - Metropolitan Atlanta Rapid Transit Authority KW - Occupational safety KW - Oversight KW - Passenger trains KW - Railroad crashes KW - Single track KW - Training KW - Work zone safety UR - https://www.ntsb.gov/doclib/reports/2003/RAB0302.pdf UR - https://trid.trb.org/view/740544 ER - TY - RPRT AN - 00979279 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: METROPOLITAN ATLANTA RAPID TRANSIT AUTHORITY (MARTA) TRAIN 103, STRIKING TECHNICIANS FOULING THE TRACK NEAR MARTA AVONDALE STATION IN DECATUR, GEORGIA, FEBRUARY 25, 2000 PY - 2003/08/08 SP - 8 p. AB - On February 25, 2000, about 8:13 a.m., eastbound Metropolitan Atlanta Rapid Transit Authority (MARTA) train 103 struck two automatic train control technicians who were inspecting signal equipment on the main track near Avondale Station in Decatur, Georgia. One of the technicians was fatally injured, and the other sustained serious injuries. The probable cause of the accident was the failure of MARTA to ensure that written safe clearance procedures were followed for employees doing inspections on the right-of-way. As a result of the accident, on March 10, 2000, MARTA issued a General Order, which specifically addresses the protection and safety of all personnel whose job requires them to enter the MARTA rail system wayside for inspections. After the accident, MARTA reviewed its operations and maintenance rules and practices and made the following changes: it improved its training of operations and maintenance employees in wayside access procedures, and it added a requirement that its supervisors do daily audits of employees' compliance with rules and safety procedures. The Georgia Department of Transportation has accompanied MARTA supervisors while they do the audits and has determined that the audits are effective. KW - Auditing KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Georgia KW - Georgia Department of Transportation KW - Inspectors KW - Maintenance practices KW - Metropolitan Atlanta Rapid Transit Authority KW - Occupational safety KW - Operating rules KW - Passenger trains KW - Railroad crashes KW - Railroad safety KW - Right of way (Land) UR - https://www.ntsb.gov/doclib/reports/2003/RAB0303.pdf UR - https://trid.trb.org/view/740543 ER - TY - RPRT AN - 00979278 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: DERAILMENT OF AMTRAK AUTO TRAIN P052-18 ON THE CSXT RAILROAD NEAR CRESCENT CITY, FLORIDA, APRIL 18, 2002 PY - 2003/08/05 SP - 82 p. AB - About 5:08 p.m. on April 18, 2002, northbound Amtrak train P052-18, the Auto Train, derailed 21 of 40 cars on CSX Transportation (CSXT) track near Crescent City, Florida. The train derailed in a left-hand curve while traveling about 56 mph. The train was carrying 413 passengers and 33 Amtrak employees. The derailment resulted in 4 fatalities, 36 serious injuries, and 106 minor injuries. The equipment and track costs associated with the accident totaled about $8.3 million. The National Transportation Safety Board determines that the probable cause of the derailment was a heat-induced track buckle that developed because of inadequate CSXT track-surfacing operations, including misalignment of the curve, insufficient track restraint, and failure to reestablish an appropriate neutral rail temperature. The safety issues addressed in the report are: continuous welded rail temperature control; continuous welded rail restraint, including ballast and rail anchors; continuous welded rail maintenance procedures and standards; means of end-of-train device activation; Amtrak passenger accountability procedures; and securement of folding armchairs on Amtrak Superliner sleeper cars. Other items discussed in the report include: suitability of the Auto Train consist and crashworthiness of the passenger car windows. As a result of its investigation of this accident, the Safety Board makes safety recommendations to CSXT, Amtrak, the Federal Railroad Administration, and the Transportation Security Administration. KW - Amtrak KW - Buckling KW - Continuous welded rail KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - CSX Transportation KW - Derailments KW - Florida KW - Heat KW - Maintenance management KW - Maintenance of way KW - Railroad crashes KW - Railroad tracks KW - Seats KW - Surfacing KW - Temperature control KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0302.pdf UR - https://trid.trb.org/view/740542 ER - TY - RPRT AN - 00974061 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: UNCONTROLLED MOVEMENT, COLLISION, AND PASSENGER FATALITY ON THE ANGELS FLIGHT RAILWAY IN LOS ANGELES, CALIFORNIA, FEBRUARY 1, 2001 PY - 2003/08/05 SP - 56 p. AB - About 12:17 p.m. on February 1, 2001, the two cars of the Angels Flight funicular railway collided in downtown Los Angeles, California. The accident resulted in 7 injuries and 1 fatality among the 20 passengers aboard the two cars and injuries to a pedestrian. The Angels Flight Operating Company estimated monetary damage to the cars at $370,000 with an additional $1.2 million to replace the funicular haul system. The National Transportation Safety Board determines that the probable cause of this accident was the Yantrak Company's (Lift Engineering's) improper design and construction of the Angels Flight funicular drive and the failure of the City of Los Angeles Community Redevelopment Agency, its contractors, and the California Public Utilities Commission to ensure that the railway system conformed to initial safety design specifications and known funicular safety standards. The major safety issues identified in this investigation are: (1) the adequacy of the safety oversight of the Angels Flight reconstruction project; (2) the adequacy of the design of the reconstructed Angels Flight system; (3) the adequacy and appropriateness of the braking systems designed for Angels Flight; and (4) the adequacy of Angels Flight Operating Company's maintenance and operating procedures. As a result of the investigation, the National Transportation Safety Board makes safety recommendations to the California Public Utilities Commission, the City of Los Angeles Community Redevelopment Agency, and the American National Standards Institute. KW - Angels Flight Railway KW - Cable railroads KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crashes KW - Design KW - Los Angeles (California) KW - Maintenance practices KW - Motion KW - Oversight KW - Railroad cars KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Train operations KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0303.pdf UR - https://trid.trb.org/view/697851 ER - TY - RPRT AN - 00965950 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: LOSS OF PITCH CONTROL ON TAKEOFF, EMERY WORLDWIDE AIRLINES, FLIGHT 17, MCDONNELL DOUGLAS DC-8-71F, N8079U, RANCHO CORDOVA, CALIFORNIA, FEBRUARY 16, 2000 PY - 2003/08/05 SP - 121 p. AB - This report explains the accident involving Emery Worldwide Airlines flight 17, a McDonnell Douglas DC-8-71F, which crashed in an automobile salvage yard shortly after takeoff, while attempting to return to Sacramento Mather Airport, Rancho Cordova, California, for an emergency landing. Safety issues discussed in this report include DC-8 elevator position indicator installation and usage, adequacy of DC-8 maintenance work cards (required inspection items), and DC-8 elevator control tab design. Safety recommendations are addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Aircraft KW - Aviation safety KW - California KW - Design KW - Elevators (Airplanes) KW - Emergencies KW - Inspection KW - Landing KW - Maintenance KW - Pitch (Dynamics) KW - Takeoff UR - https://www.ntsb.gov/doclib/reports/2003/AAR0302.pdf UR - https://trid.trb.org/view/678152 ER - TY - RPRT AN - 00967094 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-22 AND H-03-24 THROUGH H-03-27 PY - 2003/08/04 SP - 9 p. AB - These safety recommendations, addressed to Mr. William Clay Ford, Jr., President and Chief Executive Office, Ford Motor Company, and Mr. G. Richard Wagoner, Jr., President and Chief Executive Officer, General Motors Corporation recommend that Ford Motor Company and General Motors Corporation, (1) in cooperation with the American Driver and Traffic Safety Education Association, the National Safety Council, the American Automobile Association, and each other develop a training program that incorporates the skills required for safe operation of 12- and 15-passenger vans and addresses the consequences of unsafe operation, including, but not limited to, operating in a fully loaded condition, emergency braking, high-speed lane changes, tire blowouts, and tire pressure and maintenance (H-03-22); (2) voluntarily develop and install technologies to provide upper interior component protection within 12- and 15-passenger vans by model year 2006 (H-03-24); (3) voluntarily install lap/shoulder belts at all center seating positions in 12- and 15-passenger vans and make all lap/shoulder belts in outboard and center seating positions adjustable by model year 2006 (H-03-25); (4) Redesign the seat belts in their 12- and 15-passenger vans to ensure that the buckle and latch components remain readily accessible to occupants at all times by model year 2006 (H-03-26); (5) voluntarily redesign 12- and 15-passenger vans to minimize the extent to which survivable space is compromised in the event of a rollover accident by model year 2006 (H-03-27). KW - 12- and 15-passenger vans KW - Blowouts KW - Braking KW - Buckles (Fasteners) KW - Driver training KW - Emergencies KW - Ford Motor Company KW - General Motors Corporation KW - Highway safety KW - Lane changing KW - Loads KW - Maintenance KW - Recommendations KW - Rollover crashes KW - Seat belts KW - Seats KW - Speed KW - Technology KW - Tire pressure KW - Tires KW - Traffic safety KW - Vehicle compartments KW - Vehicle design KW - Vehicle padding KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_22_24_27.pdf UR - https://trid.trb.org/view/678465 ER - TY - RPRT AN - 00967095 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-22 PY - 2003/08/04 SP - 5 p. AB - This safety recommendation, addressed to Mr. J. Peter Kissinger, Foundation President and Chief Executive Officer, American Automobile Association Foundation for Traffic Safety, and Mr. Alan C. McMillen, President and Chief Executive Office, National Safety Council recommends that the American Automobile Association and the National Safety Council in cooperation with the National Highway Safety Administration, American Driver and Traffic Safety Education Association, General Motors Corporation, and Ford Motor Company, and each other, develop a training program that incorporates the skills required for safe operation of 12- and 15-passenger vans and addresses the consequences of unsafe operation, including, but not limited to, operating in a fully loaded condition, emergency braking, high-speed lane changes, tire blowouts, and tire pressure and maintenance (H-03-12). KW - 12- and 15-passenger vans KW - Abilities KW - Blowouts KW - Braking KW - Driver training KW - Emergencies KW - Highway safety KW - Lane changing KW - Loads KW - Maintenance KW - Recommendations KW - Speed KW - Tire pressure KW - Tires KW - Traffic safety UR - http://www.ntsb.gov/doclib/recletters/2003/H03_22.pdf UR - https://trid.trb.org/view/678466 ER - TY - RPRT AN - 00967096 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-23 PY - 2003/08/04 SP - 3 p. AB - This safety recommendation, addressed to Ms. Linda Lewis, President and Chief Executive Officer, American Association of Motor Vehicle Administrators recommends that the American Association of Motor Vehicle Administrators revise their Passenger Vehicles and Light Trucks Inspection Handbook to provide guidance on inspecting and failing tires for extensive weather checking or deterioration on examining tires to ensure that they have the proper load rating (H-03-23). KW - Deterioration by environmental action KW - Highway safety KW - Inspection KW - Light trucks KW - Loads KW - Passenger vehicles KW - Ratings KW - Recommendations KW - Tires KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_23.pdf UR - https://trid.trb.org/view/678467 ER - TY - RPRT AN - 00967093 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-21 PY - 2003/08/04 SP - 5 p. AB - This safety recommendation, addressed to Mr. Kal Kelliher, President, American Driver and Traffic Safety Education Association recommends that the American Driver and Traffic Safety Education Association, in cooperation with the National Highway Traffic Safety Administration, the American Automobile Association, General Motors Corporation and Ford Motor Company, develop a training program that incorporates the skills required for safe operation of 12- and 15-passenger vans and addresses the consequences of unsafe operation, including, but not limited to, operating in a fully loaded condition, emergency braking, high-speed lane changes, tire blowouts, and tire pressure and maintenance (H-03-21). KW - 12- and 15-passenger vans KW - Blowouts KW - Braking KW - Drivers KW - Driving KW - Emergencies KW - Highway safety KW - Lane changing KW - Loads KW - Maintenance KW - Recommendations KW - Speed KW - Tire pressure KW - Tires KW - Traffic safety KW - Training KW - Vans UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_21.pdf UR - https://trid.trb.org/view/678464 ER - TY - RPRT AN - 00967089 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-12 THROUGH H-03-17 PY - 2003/08/04 SP - 12 p. AB - These safety recommendations, addressed to the Honorable Jeffrey W. Runge, MD, Administrator, National Highway Traffic Safety Administration recommend that the National Highway Traffic Safety Administration (1) in cooperation with the Federal Motor Carrier Safety Administration, revise its definitions of buses and commercial motor vehicles to apply consistently to 12- and 15-passenger vans, taking into account the unique operating characteristics and multiple functions of these vans (H-03-12); (2) in cooperation with the American Driver and Traffic Safety Education Association, the National Safety Council, the American Automobile Association, General Motors Corporation, and Ford Motor Company, develop a training program that incorporates the skills required for safe operation of 12- and 15-passenger vans and addresses the consequences of unsafe operation, including, but not limited to, operating in a fully loaded condition, emergency braking, high-speed lane changes, tire blowouts, and tire pressure and maintenance (H-03-13); (3) include 12- and 15-passenger vans in Federal Motor Vehicle Safety Standard 201, Section 6, "Requirements for Upper Interior Component Protection" (H-03-14); (4) include 12- and 15-passenger vans in their upcoming rulemaking that will require lap/shoulder belts at all center seats (H-03-15); (5) include 12- and 15-passenger vans in Federal Motor Vehicle Safety Standard 216, "Roof Crush Resistance," to minimize the extent to which survivable space is compromised in the event of a rollover accident (H-03-16); and (6) in developing long-term performance requirements for tire pressure monitoring systems, adopt more stringent detection standards than 25 or 30 percent below manufacturer-recommended levels, since pressures at those levels can have an adverse effect on the handling of vehicles, such as 12- and 15-passenger vans (H-03-17). KW - 12- and 15-passenger vans KW - Blowouts KW - Braking KW - Buses KW - Commercial vehicles KW - Driving KW - Emergencies KW - Highway safety KW - Lane changing KW - Maintenance KW - Recommendations KW - Speed KW - Tire pressure KW - Tires KW - Traffic safety KW - Training KW - Vans UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_12_17.pdf UR - https://trid.trb.org/view/678460 ER - TY - RPRT AN - 00967090 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-18 PY - 2003/08/04 SP - 3 p. AB - This safety recommendation, addressed to Ms. Annette M. Sandberg, Acting Administrator, Federal Motor Carrier Safety Administration, recommends that the Motor Carrier Safety Administration in cooperation with the National Highway Traffic Safety Administration, revise its definitions of buses and commercial motor vehicles to apply consistently to 12- and 15-passenger vans, taking into account the unique operating characteristics and multiple functions of these vans (H-03-18). KW - 12- and 15-passenger vans KW - Buses KW - Commercial vehicles KW - Definitions KW - Highway safety KW - Recommendations KW - Traffic safety KW - Vans UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_18.pdf UR - https://trid.trb.org/view/678461 ER - TY - RPRT AN - 00967092 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-19 AND H-03-20 PY - 2003/08/04 SP - 6 p. AB - These safety recommendations, addressed to the Honorable Rick Perry, Governor, State of Texas recommend that the State of Texas (1) establish a driver's license endorsement for 12- and 15-passenger vans that adopts the standards established by the American driver and Traffic Safety Education Association; to obtain the endorsement, drivers should have to complete a training program on the operation of 12- and 15-passenger vans and pass a written and skills test (H-03-19); (2) require that all passenger vehicle inspections include (a) tire pressure measurement and correction of any inflation deficiencies detected and (b) identification and failure of those tires that exhibit extensive weather checking and deterioration or that are not properly load-rated (H-03-20). KW - 12- and 15-passenger vans KW - Deterioration KW - Driver licenses KW - Driver licensing KW - Drivers KW - Driving KW - Highway safety KW - Inspection KW - Loads KW - Measurement KW - Recommendations KW - Texas KW - Tire pressure KW - Traffic safety KW - Training KW - Vans KW - Weather UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_19_20.pdf UR - https://trid.trb.org/view/678463 ER - TY - RPRT AN - 00967091 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-19 PY - 2003/08/04 SP - 4 p. AB - This safety recommendation, addressed to the governors of 48 states and the Mayor of the District of Columbia recommends that the States and the District of Columbia establish a driver's license endorsement for 12- and 15-passenger vans that adopts the standards established by the American driver and Traffic Safety Education Association; to obtain the endorsement, drivers should have to complete a training program on the operation of 12- and 15-passenger vans and pass a written and skills test (H-03-19). KW - 12- and 15-passenger vans KW - Driver licenses KW - Driver licensing KW - Drivers KW - Driving KW - Highway safety KW - Recommendations KW - Testing KW - Traffic safety KW - Training KW - Vans UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_19.pdf UR - https://trid.trb.org/view/678462 ER - TY - RPRT AN - 00979281 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: DERAILMENT OF NORFOLK SOUTHERN TRAIN 15T AT FARRAGUT, TENNESSEE, SEPTEMBER 15, 2002 PY - 2003/07/21 SP - 8 p. AB - About 11:20 a.m. on September 15, 2002, a westbound Norfolk Southern Railway train derailed in Farragut, Tennessee, while moving at 38 mph. The train was made up of 3 locomotives, 56 loads, and 86 empties; a total of 142 cars with a gross weight of 9,948 tons. Two locomotives and the first 25 cars derailed. A tank car containing sulfuric acid was punctured, releasing a cloud of toxic fumes that prompted local responders to evacuate about 2,600 people from a 4.4-square mile area around the site. The evacuation lasted for about 2 1/2 days. Several local residents were treated for minor respiratory difficulties. Damages were estimated to be $1.02 million. The National Transportation Safety Board determined that the probable cause of the derailment was (1) the decision by the train dispatcher and signal maintainer to allow the train to pass over the spring switch at maximum authorized speed before the switch had been adequately inspected or clamped closed; and (2) the lack of company procedures requiring that train dispatchers, after receiving a report of a problem involving a main track switch, immediately stop trains or implement an appropriate speed restriction in the affected area. As a result of its investigation of this accident, the National Transportation Safety Board made safety recommendations to the Federal Railroad Administration and the Norfolk Southern Railway. KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Derailments KW - Dispatchers KW - Evacuation KW - Human factors in crashes KW - Norfolk Southern Corporation KW - Poisonous gases KW - Railroad crashes KW - Railroad safety KW - Speed KW - Sulfuric acid KW - Switches (Railroads) KW - Tennessee KW - U.S. Federal Railroad Administration KW - U.S. National Transportation Safety Board UR - https://www.ntsb.gov/doclib/reports/2003/RAB0305.pdf UR - https://trid.trb.org/view/740545 ER - TY - RPRT AN - 00972561 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: 15-PASSENGER VAN SINGLE-VEHICLE ROLLOVER ACCIDENTS, HENRIETTA, TEXAS, MAY 8, 2001, AND RANDLEMAN, NORTH CAROLINA, JULY 1, 2001 PY - 2003/07/15 SP - 116 p. AB - On May 8, 2001, a 1993 Dodge 15-passenger van was eastbound on U.S. Route 82 near Henrietta, Texas. The driver and 11 passengers, all members of the First Assembly of God Church in Burkburnett, Texas, occupied the van. As the vehicle approached milepost 538, the left rear tire experienced a tread separation and blowout; subsequently, the van departed the roadway and rolled over at least two times, ejecting seven passengers. The driver and three of the ejected passengers sustained fatal injuries, and eight passengers sustained serious injuries. On July 1, 2001, a 1989 Dodge Ram 15-passenger van was northbound in the left lane on U.S. Route 220, near Randleman, North Carolina. The van, owned by Virginia Heights Baptist Church of Roanoke, Virginia, was occupied by the driver and 13 passengers. As the vehicle approached the Level Cross, North Carolina, exit, the left rear tire experienced a tread separation and blowout; subsequently, the van overturned, ejecting four passengers. One ejected passenger was fatally injured, and three sustained serious injuries; the driver and nine passengers sustained injuries ranging from none to serious. The major safety issues discussed in this report are 15-passenger van classification, driver training, occupant protection, and tire condition, inspection, and maintenance. As a result of its investigation of these accidents, the Safety Board made recommendations to the National Highway Traffic Safety Administration, the Federal Motor Carrier Safety Administration, the 50 States and the District of Columbia, the American Driver and Traffic Safety Education Association, the American Automobile Association, the National Safety Council, the American Association of Motor Vehicle Administrators, Ford Motor Company, and General Motors Corporation. KW - 15-passenger vans KW - Blowouts KW - Classification KW - Dodge automobile KW - Driver training KW - Drivers KW - Ejection KW - Fatalities KW - Highway safety KW - Injuries KW - Inspection KW - Maintenance KW - North Carolina KW - Occupant protection devices KW - Passengers KW - Recommendations KW - Rollover crashes KW - Single vehicle crashes KW - Texas KW - Tire treads KW - Tires KW - Traffic crashes KW - Traffic safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0303.pdf UR - https://trid.trb.org/view/697203 ER - TY - RPRT AN - 00967085 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-09 PY - 2003/06/13 SP - 3 p. AB - This safety recommendation, addressed to the Honorable John E. Baldacci, Governor, State of Maine recommends that the State of Maine add driver distraction codes, including codes for interactive wireless communication device use, to their traffic accident investigation forms (H-03-09). KW - Cellular telephones KW - Crash investigation KW - Distraction KW - Drivers KW - Forms of business or industry KW - Highway safety KW - Maine KW - Recommendations KW - Traffic crashes KW - Traffic safety KW - Wireless communication systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_09.pdf UR - https://trid.trb.org/view/678456 ER - TY - RPRT AN - 00967087 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-11 PY - 2003/06/13 SP - 4 p. AB - This safety recommendation, addressed to Ms. Peggy Colon, President and Chief Executive Officer, The Advertising Council, Incorporated, recommends that The Advertising Council, Incorporated develop, in conjunction with the National Highway Traffic Safety Administration, a media campaign stressing the dangers associated with distracted driving (H-03-11). KW - Campaigns KW - Distraction KW - Driving KW - Hazards KW - Highway safety KW - Mass media KW - Recommendations KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_11.pdf UR - https://trid.trb.org/view/678458 ER - TY - RPRT AN - 00967086 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-10 PY - 2003/06/13 SP - 4 p. AB - This safety recommendation, addressed to Mr. Kal Kelliher, President, American Driver and Traffic Safety Education Association, recommends that the American Driver and Traffic Safety Education Association develop, in conjunction with the National Highway Traffic Safety Administration, a module for driver education curriculums that emphasizes the risks of engaging in distracting behavior (H-03-10). KW - Behavior KW - Curricula KW - Distraction KW - Driver education KW - Drivers KW - Highway safety KW - Recommendations KW - Risk taking KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_10.pdf UR - https://trid.trb.org/view/678457 ER - TY - RPRT AN - 00967082 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-03 THROUGH H-03-07 PY - 2003/06/13 SP - 7 p. AB - These safety recommendations, addressed to the Honorable Jeffrey W. Runge, Administrator, National Highway Traffic Safety Administration recommend that the National Highway Traffic Safety Administration (1) develop, in conjunction with The Advertising Council, Incorporated, a media campaign stressing the dangers associated with distracted driving (H-03-03); (2) develop, in conjunction with the American Driver and Traffic Safety Education Association, a module for driver education curriculums that emphasizes the risks of engaging in distracting behavior (H-03-04); (3) determine the magnitude and impact of driver-controlled, in-vehicle distractions, including the use of interactive wireless communication devices, on highway safety and report their findings to the U.S. Congress and the States (H-03-05); (4) expand their current evaluation of electronic stability control systems and determine their potential for assisting drivers in maintaining control of passenger cars, light trucks, sport utility vehicles, and vans. Include in this evaluation an accident data analysis of electronic stability control-equipped vehicles in the U.S. fleet (H-03-06). (5) If the results of their evaluation of electronic stability control systems are favorable, initiate a phased-in electronic stability control mandate for passenger cars, light trucks, sport utility vehicles, and vans (H-03-07). KW - Advertising campaigns KW - Analysis KW - Cellular telephones KW - Crash data KW - Distraction KW - Driver education KW - Driving KW - Electronic stability control KW - Hazards KW - Highway safety KW - Light trucks KW - Mass media KW - Passenger vehicles KW - Recommendations KW - Risk taking KW - Sport utility vehicles KW - Stability (Mechanics) KW - Traffic safety KW - Vans KW - Wireless communication systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_03_07.pdf UR - https://trid.trb.org/view/678453 ER - TY - RPRT AN - 00967083 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-08 PY - 2003/06/13 SP - 6 p. AB - This safety recommendation, addressed to the governors of fifteen states, recommends that the 48 states that do not have legislation prohibiting holders of learner's permits and intermediate licenses from using interactive wireless communication devices enact legislation to prohibit holders of learner's permits and intermediate licenses from using interactive wireless communication devices while driving (H-03-08). KW - Cellular telephones KW - Distraction KW - Drivers KW - Graduated licensing KW - Hazards KW - Highway safety KW - Intermediate licenses KW - Legislation KW - Novices KW - Recommendations KW - States KW - Traffic safety KW - Wireless communication systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_08.pdf UR - https://trid.trb.org/view/678454 ER - TY - RPRT AN - 00979282 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION OF TWO BURLINGTON NORTHERN SANTA FE FREIGHT TRAINS NEAR CLARENDON, TEXAS, MAY 28, 2002 PY - 2003/06/03 SP - 40 p. AB - At 8:57 a.m. on May 28, 2002, an eastbound Burlington Northern Santa Fe (BNSF) coal train collided head on with a westbound BNSF intermodal train near Clarendon, Texas. Both trains had a crew of two, and all crewmembers jumped from their trains before the impact. The conductor and engineer of the coal train were critically injured. The conductor of the intermodal train received minor injuries; the engineer of the intermodal train was fatally injured. The collision resulted in a subsequent fire that damaged or destroyed several of the locomotives and other railroad equipment. Damages exceeded $8 million. The National Transportation Safety Board determined that the probable cause of the collision was (1) the coal train engineer's use of a cell phone during the time he should have been attending to the requirements of the track warrant his train was operating under; and (2) the unexplained failure of the conductor to ensure that the engineer complied with the track warrant restrictions. Contributing to the accident was the absence of a positive train control system that would have automatically stopped the coal train before it exceeded its authorized limits. As a result of its investigation of this accident, the Safety Board identified the following safety issues: the use of cell phones by railroad operating crews; the issuance to moving trains of track warrant authority that contains an after-arrival stipulation; and the lack of positive train control. The Safety Board made recommendations to the Federal Railroad Administration and the General Code of Operating Rules Committee. KW - Automatic train control KW - BNSF Railway KW - Cellular telephones KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Fatalities KW - Freight trains KW - Frontal crashes KW - Injuries KW - Railroad crashes KW - Railroad safety KW - Texas KW - Track warrants UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0301.pdf UR - https://trid.trb.org/view/740546 ER - TY - RPRT AN - 00963130 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: FORD EXPLORER SPORT COLLISION WITH FORD WINDSTAR MINIVAN AND JEEP GRAND CHEROKEE ON INTERSTATE 95/495 NEAR LARGO, MARYLAND, FEBRUARY 1, 2002 PY - 2003/06/03 SP - 71 p. AB - On February 1, 2002, on interstate 95/495 near Largo, Maryland, a 1998 Ford Explorer Sport, traveling northbound, veered off the left side of the roadway, crossed over the median, climbed up a guardrail, flipped over, and landed on top of a southbound 2001 Ford Windstar minivan. Subsequently, a 1998 Jeep Cherokee ran into the minivan. Of the eight people involved in the accident, five adults were fatally injured, one adult sustained minor injuries, and two children were uninjured. The following safety issues were identified in this accident: the accident driver's speed, operating inexperience, and unfamiliarity with the vehicle; the use of a wireless telephone while operating a vehicle; the need for technology to aid vehicle stability; and the adequacy of the existing barrier system. As a result of this accident investigation, the National Transportation Safety Board issued recommendations to the National Highway Traffic Safety Administration, 49 states (exclusion -- New Jersey), the American Driver and Traffic Safety Education Association, and The Advertising Council, Inc. The Safety Board also reiterates Safety Recommendations H-98-12 and -24 to the Federal Highway Administration and the American Association of State Highway and Transportation Officials, respectively. KW - Adults KW - Cellular telephones KW - Children KW - Driver experience KW - Drivers KW - Familiarity with vehicle KW - Fatalities KW - Ford Explorer KW - Ford minivan KW - Highway safety KW - Injuries KW - Jeep Grand Cherokee KW - Median barriers KW - Passengers KW - Rollover crashes KW - Speed KW - Sport utility vehicles KW - Stability (Mechanics) KW - Traffic crashes KW - Traffic safety KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0302.pdf UR - https://trid.trb.org/view/661025 ER - TY - RPRT AN - 00986819 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. GENERAL AVIATION, CALENDAR YEAR 1999 PY - 2003/05/29 SP - 56 p. AB - A total of 1,933 aircraft were involved in 1,906 accidents during calendar year 1999. The total number of general aviation accidents occurring in 1999 was virtually unchanged from calendar year 1998, with an increase of only two accidents. Of the total number of accidents, 340 were fatal, resulting in a total of 619 fatalities. The number of general aviation accidents in 1999 represented a 6.6% decrease from calendar year 1998 although the number of resulting fatalities decreased by only 0.8% during that period. The circumstances of these accidents and the details related to the aircraft, pilots, and locations involved are presented throughout this report. KW - Aviation safety KW - Crash characteristics KW - Crash data KW - Crash locations KW - Fatalities KW - General aviation UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARG03-02.pdf UR - https://trid.trb.org/view/748220 ER - TY - RPRT AN - 00979283 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT BRIEF: COLLISION OF AMTRAK TRAIN NO. 90 AND MARC TRAIN NO. 437, BALTIMORE, MARYLAND, JUNE 17, 2002 PY - 2003/05/12 SP - 5 p. AB - About 5:42 p.m. on June 17, 2002, northbound Amtrak train No. 90, The Palmetto, collided with southbound MARC train No. 437 in Baltimore, Maryland. Amtrak train No. 90 consisted of 2 locomotives and 11 cars. There were 141 passengers and 6 crewmembers on board. MARC train No. 437 consisted of 1 locomotive and 7 cars. There were 60 passengers and 4 crewmembers on board. The collision resulted in six minor injuries. The National Transportation Safety Board determined that the probable cause of this accident was the Amtrak engineer's loss of situational awareness in the moments before the collision because of excess focus on regulating train speed, which led to a failure to comply with signal indications. Contributing to the accident was the engineer's lack of familiarity with and proficiency in the operation of the diesel-electric locomotives assigned for the trip and the lack of a positive train control system. Since the accident, Amtrak representatives have stated that the company has thoroughly reviewed the procedures used to track and document the demonstrated proficiencies of student engineers. Immediately following the accident, Amtrak amended its evaluation program to permit greater scrutiny of the proficiency of its newly promoted engineers, as well as of its experienced engineers who were newly hired from other carriers. KW - Amtrak KW - Automatic train control KW - Awareness KW - Baltimore (Maryland) KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Crashes KW - Human factors in crashes KW - Locomotive engineers KW - Passenger trains KW - Railroad crashes KW - U.S. National Transportation Safety Board UR - https://www.ntsb.gov/doclib/reports/2003/RAB0301.pdf UR - https://trid.trb.org/view/740547 ER - TY - RPRT AN - 00964776 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. GENERAL AVIATION, CALENDAR YEAR 1998 PY - 2003/03/20 SP - 52 p. AB - A total of 1,928 aircraft were involved in 1,904 accidents during calendar year 1998. The total number of general aviation accidents occurring in 1998 represented a 3.2% increase over calendar year 1997. Of the total number of accidents, 364 were fatal accidents that resulted in a total of 624 fatalities. Although the number of fatal general aviation accidents in 1998 represented a 4% increase over calendar year 1997, the number of resulting fatalities declined 1.1% between 1997 and 1998. The circumstances of these accidents and the details related to the aircraft, pilots, and locations involved are represented throughout this report. KW - Air transportation crashes KW - Crash data KW - Fatalities KW - General aviation KW - Trend (Statistics) UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARG03-01.pdf UR - https://trid.trb.org/view/661508 ER - TY - RPRT AN - 00943560 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION OF A GREYHOUND LINES, INC. MOTORCOACH AND DELCAR TRUCKING TRUCK TRACTOR-SEMITRAILER, LORAINE, TEXAS, JUNE 9, 2002 PY - 2003/02/26 SP - 62 p. AB - On Sunday, June 9, 2002, about 5:10 a.m., near Loraine, Texas, a 1993 Motor Coach Industries MC-12 motorcoach, operated by Greyhound Lines, Inc., and occupied by the driver and 37 passengers, was traveling east on Interstate 20, on a scheduled route to Abilene, Texas, at a driver-reported speed of 65 to 67 mph. A truck tractor-semitrailer, consisting of a tractor and a semitrailer leased by DelCar Trucking, which was being operated by a driver in training with a codriver in the sleeper berth, was entering the interstate from a picnic area at a driver-estimated speed of 40 mph and proceeding into the eastbound lanes. The motorcoach collided with the rear of the semitrailer, pushing the tractor-semitrailer approximately 276 feet. Three passengers on the Greyhound bus, all seated in the front of the bus, were fatally injured. Five passengers and the bus driver were seriously injured. Twenty-four passengers sustained minor injuries. The truck driver also sustained a minor injury. The National Transportation Safety Board determines that the probable cause of this accident was the unnecessarily slow acceleration of the unlighted semitrailer onto a high-speed interstate by an inexperienced and unsupervised driver who was impaired by cocaine. Contributing to the accident was DelCar Trucking's failure to exercise adequate operational oversight and the Federal Motor Carrier Safety Administration's failure to ensure the safety of and provide management oversight for new entrant motor carriers. As a result of this accident investigation, which focuses upon the safety of and management oversight for new entrant motor carriers, the Safety Board makes two recommendations to the Federal Motor Carrier Safety Administration. KW - Bus crashes KW - Buses KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Crashes KW - Delcar Trucking KW - Driver training KW - Drugged drivers KW - Fatalities KW - Human factors in crashes KW - Injuries KW - Interstate highways KW - Motor carriers KW - Oversight KW - Recommendations KW - Speed KW - Texas KW - Tractor trailer combinations KW - Traffic crashes KW - Truck crashes KW - Truck drivers KW - Trucking safety KW - U.S. Federal Motor Carrier Safety Administration UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0301.pdf UR - https://trid.trb.org/view/643623 ER - TY - RPRT AN - 01014933 AU - National Transportation Safety Board TI - Pipeline Accident Report: Natural Gas Pipeline Rupture and Fire Near Carlsbad, New Mexico, August 19, 2000 PY - 2003/02/11 SP - 66p AB - At 5:26 a.m., mountain daylight time, on Saturday, August 19, 2000, a 30-inch-diameter natural gas transmission pipeline operated by El Paso Natural Gas Company ruptured adjacent to the Pecos River near Carlsbad, New Mexico. The released gas ignited and burned for 55 minutes. Twelve persons who were camping under a concrete-decked steel bridge that supported the pipeline across the river were killed and their three vehicles destroyed. Two nearby steel suspension bridges for gas pipelines crossing the river were extensively damaged. According to El Paso Natural Gas Company, property and other damages or losses totaled $998,296. The major safety issues identified in this investigation are the design and construction of the pipeline, the adequacy of El Paso Natural Gas Company's internal corrosion control program, the adequacy of Federal safety regulations for natural gas pipelines, and the adequacy of Federal oversight of the pipeline operator. As a result of its investigation of this accident, the National Transportation Safety Board makes safety recommendations to the Research and Special Programs Administration and NACE International. KW - Bridges KW - Carlsbad (New Mexico) KW - Construction KW - Corrosion protection KW - Design KW - Fatalities KW - Federal government KW - Fire KW - Loss and damage KW - Natural gas pipelines KW - Operators (Persons) KW - Oversight KW - Pecos River KW - Pipeline accidents KW - Pipeline companies KW - Pipeline safety KW - Recommendations KW - Regulations KW - Rupture UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0301.pdf UR - https://trid.trb.org/view/771519 ER - TY - RPRT AN - 00960464 AU - National Transportation Safety Board TI - COLLISION BETWEEN THE U.S. COAST GUARD PATROL BOAT CG242513 AND THE U.S. SMALL PASSENGER VESSEL BAYSIDE BLASTER, BISCAYNE BAY, FLORIDA, JANUARY 12, 2002 PY - 2003 SP - 56 p. AB - This report discusses the collision that occurred on the evening of January 12, 2002, between the U.S. Coast Guard patrol boat CG242513, which was on a routing patrol of Biscayne Bay, Florida, and the small passenger vessel Bayside Blaster, which was on a sightseeing tour of the area. The accident resulted in no deaths or serious injuries. However, both Coast Guard crew members and 2 of the Bayside Blaster's passengers were taken to a hospital for examination. Damages to the patrol boat (which was a total loss), the Bayside Blaster, and a moored recreational boat totaled $184,722. From its investigation of the accident, the National Transportation Safety Board identified safety issues regarding the adequacy of the following: operation of the Coast Guard patrol boat; operation of the Bayside Blaster; Coast Guard oversight of routine patrols; Boatrides International, Inc. (owner of the Bayside Blaster) management oversight; kill switch operation on Coast Guard nonstandard boats; lifejacket stowage on the Bayside Blaster; and Coast Guard safety oversight of small passenger vessels in Miami. On the basis of its findings, the Safety Board made recommendations to the U.S. Coast Guard, to Boatrides International, Inc., and to the Passenger Vessel Association. KW - Boats KW - Florida KW - Kill switches (boats) KW - Management KW - Marine safety KW - Oversight KW - Passenger ships KW - Patrol boats KW - Small ships KW - Tourists KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0205.pdf UR - https://trid.trb.org/view/659944 ER - TY - JOUR AN - 00944324 JO - Highway accident report PB - National Transportation Safety Board AU - National Transportation Safety Board TI - FORD EXPLORER COLLISION WITH FORD WINDSTAR AND JEEP GRAND CHEROKEE NEAR LARGO, MARYLAND, FEBRUARY 1, 2002 PY - 2003 SP - 3 p. AB - This document is a synopsis of the National Transportation Safety Board highway accident report NTSB/HAR-03/02 and presents conclusions regarding the use of cellular telephones and driver distraction and contributing factors in accidents KW - Cellular telephones KW - Crashes KW - Policy UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0302.pdf UR - https://trid.trb.org/view/646586 ER - TY - RPRT AN - 00940588 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT. LOSS OF CONTROL AND IMPACT WITH PACIFIC OCEAN ALASKA AIRLINES FLIGHT 261 MCDONNELL DOUGLAS MD-83, N963AS ABOUT 2.7 MILES NORTH OF ANACAPA ISLAND, CALIFORNIA, JANUARY 31, 2000 PY - 2002/12/30 SP - 235 p. AB - This report explains the accident involving Alaska Airlines flight 261, a McDonnell Douglas MD-83, which crashed into the Pacific Ocean about 2.7 miles north of Anacapa Island, California. Safety issues discussed in this report include lubrication and inspection of the jackscrew assembly, extension of lubrication and end play check intervals, jackscrew assembly overhaul procedures, the design and certification of the MD-80 horizontal stabilizer trim control system, Alaska Airlines' maintenance program, and Federal Aviation Administration (FAA) oversight of Alaska Airlines. Safety recommendations are addressed to the FAA. KW - Alaska Airlines KW - Aviation safety KW - Crash investigation KW - Inspection KW - Lubrication KW - Maintenance practices KW - Oversight KW - Stabilizers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0201.pdf UR - https://trid.trb.org/view/731488 ER - TY - RPRT AN - 00943439 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-35 PY - 2002/12/19 SP - 5 p. AB - This safety recommendation, addressed to Daniel Senese, Executive Director, Institute of Electrical and Electronics Engineers, and S.M. Shahed, President, Society of Automotive Engineers, recommends that the Institute of Electrical and Electronics Engineers and the Society of Automotive Engineers work together, as part of their initiative to establish on-board vehicle recorder standards, to develop standards for brake and transmission electronic control units that require those units to store a full history of electronic fault codes that are time stamped using a recognized clock synchronized with other on-board event data recording devices. KW - Brakes KW - Buses KW - Data recorders KW - Electronic control KW - Electronic control units KW - Electronic fault codes KW - Institute of Electrical and Electronics Engineers KW - Motor carriers KW - Onboard vehicle recorders KW - Recommendations KW - Society of Automotive Engineers KW - Standards KW - Transmissions UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_35.pdf UR - https://trid.trb.org/view/643519 ER - TY - RPRT AN - 00943437 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-33 PY - 2002/12/19 SP - 5 p. AB - This safety recommendation, addressed to Annette M. Sandberg, Acting Administrator, Federal Motor Carrier Safety Administration (FMCSA), recommends that the FMCSA develop, in cooperation with the United Motorcoach Association and the American Bus Association, a booklet that educates motorcoach drivers on the different types of retarders and on their use during low-friction-coefficient road conditions. This information should then be distributed to motorcoach carriers and other interested parties. KW - Bus drivers KW - Driving KW - Education KW - Icy roads KW - Motor carriers KW - Recommendations KW - Truck drivers KW - U.S. Federal Motor Carrier Safety Administration KW - Vehicle retarders UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_33.pdf UR - https://trid.trb.org/view/643517 ER - TY - RPRT AN - 00943438 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-34 PY - 2002/12/19 SP - 5 p. AB - This safety recommendation, addressed to Victor S. Parra, Chief Executive Officer, United Motorcoach Association, and Peter Pantuso, President and Chief Executive Officer, American Bus Association, recommends that the American Bus Association and the United Motorcoach Association work with the Federal Motor Carrier Safety Administration to develop a booklet that educates motorcoach drivers on the different types of retarders and on their use during low-friction-coefficient road conditions. This information should then be distributed to motorcoach carriers and other interested parties. KW - American Bus Association KW - Bus drivers KW - Driving KW - Education KW - Icy roads KW - Motor carriers KW - Recommendations KW - United Motorcoach Association KW - Vehicle retarders UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_34.pdf UR - https://trid.trb.org/view/643518 ER - TY - RPRT AN - 00943561 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: MOTORCOACH RUN-OFF-THE-ROAD, NEAR CANON CITY, COLORADO, DECEMBER 21, 1999 PY - 2002/12/17 SP - 11 p. AB - About 9:05 p.m. on December 21, 1999, a 59-passenger motorcoach was traveling on State Highway 50 along a 7-mile-long downgrade west of Canon City, Colorado, when it began to fishtail while negotiating a curve near milepost (MP) 272.3. The speed limit was 65 mph, with an advisory speed limit of 55 mph on the curves. The driver recovered the vehicle from the fishtail. When the motorcoach fishtailed at MP 272.3, the transmission retarder was engaged despite icy road conditions. Following this fishtail, the driver shifted into neutral, thereby disengaging both the transmission retarder and eliminating any retarding torque provided by the transmission. Approximately 36 seconds later, as the motorcoach gained speed as it descended the mountain, the driver lost control of the vehicle on a curve. As the motorcoach continued to descend the roadway, the driver lightly applied the service brakes several times. The motorcoach drifted off the right side of the road, returned to the road, rotated, and departed the north side of the roadway backward. The vehicle rolled down a 40-foot-deep embankment and came to rest on its roof. The driver and 2 passengers were killed; 33 passengers sustained serious injuries and 24 sustained minor injuries. The accident driver appeared to be safe and conscientious, with no signs of fatigue, substance abuse or serious medical condition that would affect performance. Although the bus driver had received little training on transmission retarders, he had substantial experience driving motorcoaches. No serious mechanical problems with the motorcoach were found. The Safety Board could not determine why the driver had the retarder engaged during icy roadway conditions, why he shifted the transmission into neutral after the fishtail, and why he chose not to apply the brakes more vigorously prior to the accident. The Safety Board determines that the probable cause of this accident was the motorcoach driver's inability to control his vehicle under the icy conditions of the roadway; the driver initiated the accident sequence by inappropriately deciding to use the retarder under icy conditions. As a result of this accident, the National Transportation Safety Board recommends that a booklet be developed and disseminated to educate motorcoach drivers on the use of retarders during low-friction-coefficient road conditions. It is also recommended that standards for brake and transmission electronic control units should be developed that require those units to store a full history of time-stamped electronic fault codes. KW - Braking KW - Bus crashes KW - Bus drivers KW - Buses KW - Colorado KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Downgrades (Roads) KW - Driver education KW - Driver errors KW - Fatalities KW - Fault monitoring KW - Fishtailing KW - Icy roads KW - Injuries KW - Loss of control KW - Passengers KW - Ran off road crashes KW - Retarders (Vehicle components) KW - Rollover crashes KW - Single vehicle crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0219.pdf UR - https://trid.trb.org/view/643624 ER - TY - RPRT AN - 00943562 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SINGLE-VEHICLE MOTORCOACH ROLLOVER, NEAR PLEASANT VIEW, TENNESSEE, AUGUST 19, 2001 PY - 2002/12/11 SP - 6 p. AB - On August 19, 2001, a Greyhound motorcoach was traveling on Interstate Highway 24 near the town of Pleasant View, Tennessee (about 25 miles from its final destination of Nashville, Tennessee). The bus was traveling at or near the 70-mph speed limit in the right-hand lane when it slowly drifted across the left-hand lane, over rumble strips, off the roadway, and into the grassy median. The bus continued forward for approximately 600 feet, then came back onto the pavement at a sharp angle, and began yawing to the left. Next, the bus began turning to the left and yawing to the right and departed the pavement on the right-hand side of the road, continuing into a broadside skid. The bus overturned onto its right side, slid 198 feet on the grassy roadside, and came to rest. During the overturn, a passenger was fatally injured. The driver and the remaining 43 passengers received minor-to-serious injuries. The driver reported no mechanical problems with the bus, and a postcrash inspection indicated no defects in the brakes, steering, tires, or suspension. The driver was a full-time, extra-board driver for Greyhound and had accumulated 9 months of professional experience as a Greyhound driver at the time of the accident. Toxicology tests showed no evidence of drugs or alcohol in the driver's blood specimen. The driver in this accident had been awake for nearly 20 hours of the 24-hour period immediately preceding the accident and had reverted to an inverted work-rest cycle on his days off before the accident. However, Greyhounds scheduling practices did not prevent the driver from receiving rest, as evidenced by his reported 4-hour nap that ended 12 hours before the accident. Passengers on the bus stated they observed the driver having difficulty staying awake during the trip. The driver could not recall any events that occurred within approximately 50 miles of the accident site. The National Transportation Safety Board determines that the probable cause of this accident was driver fatigue due to inadequate sleep in the 24-hour period preceding the accident. KW - Bus crashes KW - Bus drivers KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Driver errors KW - Fatalities KW - Fatigue (Physiological condition) KW - Hours of labor KW - Injuries KW - Loss of control KW - Passengers KW - Rollover crashes KW - Schedules KW - Single vehicle crashes KW - Sleep deprivation KW - Tennessee UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0218.pdf UR - https://trid.trb.org/view/643625 ER - TY - RPRT AN - 00979284 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION OF TWO CANADIAN NATIONAL/ILLINOIS CENTRAL RAILWAY TRAINS NEAR CLARKSTON, MICHIGAN, NOVEMBER 15, 2001 PY - 2002/11/19 SP - 40 p. AB - On November 15, 2001, about 5:54 a.m., Canadian National/Illinois Central Railway (CN/IC) southbound train 533 and northbound train 243 collided near Clarkston, Michigan. The collision occurred on the CN/IC Holly Subdivision at a switch at the south end of a siding designated as the Andersonville siding. Train 533 had been operating in a southward direction through the siding and was traveling at 13 mph when it struck train 243. Signal 14LC at the turnout for the siding displayed a stop indication, but train 533 did not stop before proceeding onto the mainline track. Train 243 was operating northward on a proceed signal on the single main track about 30 mph when the trains collided. Both crewmembers of train 243 were fatally injured; the two crewmembers of train 533 sustained serious injuries. The total cost of the accident was approximately $1.4 million. The National Transportation Safety Board determined that the probable cause of the accident was the train 533 crewmembers' fatigue, which was primarily due to the engineer's untreated and the conductor's insufficiently treated obstructive sleep apnea. In its investigation of this accident, the Safety Board examined one safety issue: The adequacy of rail industry standards and procedures for identifying and reporting potentially incapacitating medical conditions. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Canadian National Railway (parent organization of the CN/IC) and the Federal Railroad Administration. KW - Canadian National KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reports KW - Crashes KW - Diseases and medical conditions KW - Fatigue (Physiological condition) KW - Freight trains KW - Human factors in crashes KW - Injuries KW - Michigan KW - Railroad crashes KW - Railroad safety KW - Sidings (Railroads) KW - Sleep disorders KW - U.S. Federal Railroad Administration KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0204.pdf UR - https://trid.trb.org/view/740548 ER - TY - RPRT AN - 00936804 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-26 THROUGH H-02-28 PY - 2002/11/01 SP - 5 p. AB - This safety recommendation, addressed to the Honorable Jeffrey W. Runge, Administrator, National Highway Traffic Safety Administration recommends that the National Highway Traffic Safety Administration: (1) Include 15-passenger vans in the National Highway Traffic Safety Administration dynamic testing program. The dynamic testing should test the performance of the 15-passenger vans under various load conditions (H-02-26). (2) Extend the National Car Assessment Program (NCAP) rollover resistance program to 15-passenger vans, especially for various load conditions, and use the dynamic testing results of 15-passenger vans, as described in Safety Recommendation H-02-26, to supplement the static measures of stability in the NCAP rollover resistance program (H-02-27); (3) Evaluate, in conjunction with the manufacturers of 15-passenger vans, and test as appropriate, the potential of technological systems, particularly electronic stability control systems, to assist drivers in maintaining control of 15-passenger vans (H-02-28). KW - 15-passenger vans KW - Control KW - Drivers KW - Dynamic tests KW - Electronic control KW - Evaluation KW - Loads KW - National Car Assessment Program KW - Recommendations KW - Rollover crashes KW - Stability (Mechanics) KW - Technology KW - Tests KW - Traffic safety KW - Vans UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_26_28.pdf UR - https://trid.trb.org/view/730063 ER - TY - RPRT AN - 00936805 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-29 PY - 2002/11/01 SP - 5 p. AB - This safety recommendation, addressed to Mr. William Clay Ford, Jr., Chairman and Chief Executive Officer, Ford Motor Company and Mr. G. Richard Wagoner, Jr., President and Chief Executive Officer, General Motors Corporation, recommends that the manufacturers of 15-passenger vans evaluate, in conjunction with National Highway Traffic Safety Administration, and test as appropriate, the potential of technological systems, particularly electronic stability control systems, to assist drivers in maintaining control of 15-passenger vans (H-02-29). KW - 15-passenger vans KW - Drivers KW - Electronic control KW - Evaluation KW - Recommendations KW - Stability (Mechanics) KW - Technology KW - Testing KW - Traffic safety KW - Vans UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_29.pdf UR - https://trid.trb.org/view/730064 ER - TY - RPRT AN - 01138252 AU - National Transportation Safety Board TI - National Transportation Safety Board Aviation Investigation Manual. Major Team Investigations PY - 2002/11 SP - 376p AB - This manual provides general information to assist the investigator-in-charge (IIC), group chairmen, and others who may participate in a major aviation accident investigation. It is intended to provide guidance on the process of conducting a major investigation, from initial notification to the adoption of the final report, probable cause, and recommendations by the Members of the Safety Board. Although this publication includes some technical information related to investigative activities in major aviation accidents, it is primarily intended to provide guidance of a procedural or administrative nature. KW - Air transportation crashes KW - Aviation safety KW - Civil aviation KW - Crash investigation KW - Guidelines KW - Recommendations KW - Transportation safety KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/898346 ER - TY - RPRT AN - 00935909 AU - National Transportation Safety Board TI - SAFETY REPORT: EVALUATION OF THE ROLLOVER PROPENSITY OF 15-PASSENGER VANS PY - 2002/10/15 SP - 50 p. AB - Fifteen-passenger vans, which make up about 0.25 percent of the passenger vehicle fleet in the United States, are frequently used to transport school sports teams, van pools, church groups, and other groups. Although they are involved in a proportionate number of fatal accidents compared to their percentage in the fleet, they are involved in a higher number of single-vehicle accidents involving rollovers than are other passenger vehicles. Various factors have been associated with 15-passenger van rollover, particularly occupancy level and vehicle speed. Fully loading or nearly loading a 15-passenger van causes the center of gravity to move rearward and upward, which increases its rollover propensity and could increase the potential for driver loss of control in emergency maneuvers. The National Highway Traffic Safety Administration has been evaluating vehicle rollover for several years. The agency has initiated rulemaking activities concerning vehicle rollovers, established a rollover resistance rating system, and is currently examining dynamic testing procedures; however, these programs have not been extended to 15-passenger vans. As a result of this safety report, the National Transportation Safety Board issued safety recommendations to the National Highway Traffic Safety Administration and to the manufacturers of 15-passenger vans. KW - 15-passenger vans KW - Automobile industry KW - Center of gravity KW - Drivers KW - Emergency maneuvers KW - Evaluation KW - Fatalities KW - Loss of control KW - Passenger vehicles KW - Rollover crashes KW - Single vehicle crashes KW - Speed KW - U.S. National Highway Traffic Safety Administration KW - Vans KW - Vehicle occupancy UR - http://app.ntsb.gov/doclib/safetystudies/SR0203.pdf UR - https://trid.trb.org/view/725588 ER - TY - RPRT AN - 01014934 AU - National Transportation Safety Board TI - Pipeline Accident Report: Pipeline Rupture and Subsequent Fire in Bellingham, Washington, June 10, 1999 PY - 2002/10/08 SP - 88p AB - About 3:28 p.m., Pacific daylight time, on June 10, 1999, a 16-inch-diameter steel pipeline owned by Olympic Pipe Line Company ruptured and released about 237,000 gallons of gasoline into a creek that flowed through Whatcom Falls Park in Bellingham, Washington. About 1 1/2 hours after the rupture, the gasoline ignited and burned approximately 1 1/2 miles along the creek. Two 10-year-old boys and an 18-year-old young man died as a result of the accident. Eight additional injuries were documented. A single-family residence and the city of Bellingham's water treatment plant were severely damaged. As of January 2002, Olympic estimated that total property damages were at least $45 million. The major safety issues identified during this investigation are excavations performed by IMCO General Construction, Inc., in the vicinity of Olympic's pipeline during a major construction project and the adequacy of Olympic Pipe Line Company's inspections thereof; the adequacy of Olympic Pipe Line Company's interpretation of the results of in-line inspections of its pipeline and its evaluation of all pipeline data available to it to effectively manage system integrity; the adequacy of Olympic Pipe Line Company's management of the construction and commissioning of the Bayview products terminal; the performance and security of Olympic Pipe Line Company's supervisory control and data acquisition system; and the adequacy of Federal regulations regarding the testing of relief valves used in the protection of pipeline systems. As a result of this investigation, the National Transportation Safety Board issues safety recommendations to the Research and Special Programs Administration. KW - Bellingham (Washington) KW - Construction KW - Data collection KW - Evaluation KW - Excavations KW - Fatalities KW - Federal government KW - Fire KW - Gas pipelines KW - Injuries KW - Inspection KW - Loss and damage KW - Management KW - Performance KW - Pipeline accidents KW - Pipeline integrity management KW - Pipeline safety KW - Pressure relief valves KW - Regulations KW - Rupture KW - Security KW - Steel KW - Testing UR - https://www.ntsb.gov/doclib/reports/2002/PAR0202.pdf UR - https://trid.trb.org/view/771520 ER - TY - RPRT AN - 00974050 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT BRIEF: SCHEMPP-HIRTH NIMBUS-4DM, N807BB, MINDEN, NEVADA, JULY 13, 1999 PY - 2002/09/27 SP - 42 p. AB - On July 13, 1999, at 11:10 p.m., a motorized glider experienced an in-flight breakup while maneuvering near Minden, Nevada. The commercial glider pilot and a passenger were fatally injured, and the glider was destroyed. The glider was certificated in the United States in the experimental category for exhibition and racing, and it was also certificated in Germany in the standard class, utility category. The National Transportation Safety Board determined that the probable cause of this accident was the pilot's excessive use of the elevator control during recovery from an inadvertently entered spin and/or spiral dive during which the glider exceeded the maximum permissible speed, which resulted in the overload failure of the wings at loadings beyond the structure's ultimate design loads. KW - Air transportation crashes KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Elevator control KW - Gliders (Aircraft) KW - Nevada KW - Pilotage KW - Speed KW - U.S. National Transportation Safety Board KW - Ultimate load design UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0206.pdf UR - https://trid.trb.org/view/697840 ER - TY - RPRT AN - 01016501 AU - National Transportation Safety Board TI - Hazardous Materials Accident Report: Release and Ignition of Hydrogen Following Collision of a Tractor-Semitrailer with Horizontally Mounted Cylinders and a Pickup Truck near Ramona, Oklahoma, May 1, 2001 PY - 2002/09/17 SP - 46p AB - On May 1, 2001, a tractor-semitrailer that had horizontally mounted cylinders filled with compressed hydrogen struck a pickup truck near Ramona, Oklahoma. According to witnesses, the tractor-semitrailer then went out of control and overturned while continuing along the highway. It went off the road to the east and traveled 300 more feet before it stopped. During the process, some of its cylinders, valves, piping, and fittings were damaged and released hydrogen. The safety issues discussed in this report are the adequacy of Federal requirements for protecting cylinders that are horizontally mounted on semitrailers and the valves, piping, and fittings of the cylinders during rollover accidents and the adequacy of the information in the North American Emergency Response Guidebook about compressed hydrogen. As a result of its investigation of this accident, the Safety Board made recommendations to the Research and Special Programs Administration. KW - Compressed hydrogen KW - Crashes KW - Engine cylinders KW - Federal government KW - Fittings KW - Hazardous materials KW - Hydrogen KW - Ignition KW - North American Emergency Response Guidebook KW - Pickup trucks KW - Pipe KW - Ramona (Oklahoma) KW - Requirements KW - Rollover crashes KW - Tractor trailer combinations KW - Truck crashes KW - Trucking safety KW - Valves UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM0202.pdf UR - https://trid.trb.org/view/771674 ER - TY - RPRT AN - 01003108 AU - National Transportation Safety Board TI - Marine Accident Report: Fire On Board the Small Commuter Vessel Seastreak New York, at Sandy Hook, New Jersey, September 28, 2001 PY - 2002/09/17 SP - 34p AB - On September 28, 2001, the domestic high-speed vessel Seastreak New York was en route from Highlands, New Jersey, to New York, New York, with 198 passengers and 6 crewmembers on board. As the vessel passed Sandy Hook Point, New Jersey, about 0630, a fire broke out on the No. 3 engine in the starboard engineroom. Flames forced the deckhand who discovered the fire to flee the engineroom. Access hatches, ventilation, and fuel for the main engines in the starboard engineroom were secured. The fixed CO2 fire suppression system was then activated. The Seastreak New York proceeded to a nearby Coast Guard Station, using its port engines, and disembarked its passengers without incident. Local firefighters arrived on board at 0700. By 0730, a firefighter entered the engineroom and found that the fire had been extinguished by the CO2 suppression system. There were no personal injuries as a result of this fire, but the resultant damages were estimated at $81,000. The National Transportation Safety Board determines that the probable cause of the fire on board the Seastreak New York was the improper installation of the Centinel System’s lube oil hose, which allowed the hose to come in contact with the hot exhaust manifold. Contributing to the cause of the fire was the absence of detailed guidance from the manufacturer of the Centinel System on the proper installation of the system. Also contributing to the cause of the fire was the lack of inspection and maintenance procedures by Circle Navigation Company that might have discovered the improper installation. The major safety issues discussed in this report are the adequacy of the following: manufacturer’s instructions for the installation of engine accessories; crew firefighting response; company maintenance and inspection procedures; and passenger management. As a result of its investigation of this accident, the Safety Board makes recommendations to Cummins Engine Company, Inc., and Circle Navigation Company of New York. KW - Circle Navigation Company KW - Commuter service KW - Crash causes KW - Crash investigation KW - Cummins Engine Company KW - Evacuation KW - Fire causes KW - Fire fighting KW - Fires KW - High speed craft KW - Inspection KW - Installation KW - Maintenance management KW - Maritime safety KW - New Jersey KW - New York (State) KW - Passenger ships KW - Recommendations KW - Small ships KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0204.pdf UR - https://trid.trb.org/view/759270 ER - TY - RPRT AN - 01003110 AU - National Transportation Safety Board TI - Marine Accident Report: Grounding of the Small Passenger Vessel Finest at Sandy Hook, New Jersey, January 4, 2001 PY - 2002/09/17 SP - 40p AB - About 1930 on January 4, 2001, the domestic high-speed vessel Finest, with 258 passengers, 5 crewmembers, and one company official on board, ran aground outside the channel to the Shrewsbury River, Sandy Hook Bay, while en route from New York City, New York, to Highlands, New Jersey. The Finest refloated at 0007 on January 5, after the tide changed, and proceeded to Sandy Hook Bay Marina, where it docked at 0026 and discharged its passengers. No one on board the vessel suffered any injury, and the vessel sustained no damage. One person on board had to be evacuated from the vessel by helicopter for medical treatment of an allergic reaction unrelated to the accident. The National Transportation Safety Board determines that the probable cause of the grounding of the Finest was the failure of the vessel master to use appropriate navigational procedures and equipment to determine the vessel’s position while approaching the Shrewsbury River channel. Contributing to the cause of the grounding was the lack of readily visible fixed navigational aids. Also contributing to the cause of the grounding was the failure of New York Fast Ferry to require the use of installed navigation equipment and to set guidelines for operations in adverse environmental conditions. The major safety issues in this report are as follows: adequacy of navigational procedures; adequacy of navigational aids in the Shrewsbury River; and appropriateness of alcoholic beverage service after an accident. As a result of its investigation of this accident, the Safety Board makes one safety recommendation to the U.S. Coast Guard and three to New York Fast Ferry Services. KW - Alcohol use KW - Channels (Waterways) KW - Crash causes KW - Crash investigation KW - Groundings (Maritime crashes) KW - High speed craft KW - Maritime safety KW - Navigation KW - Navigational aids KW - New Jersey KW - New York Fast Ferry Services KW - Ship pilotage KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0203.pdf UR - https://trid.trb.org/view/759269 ER - TY - RPRT AN - 00943550 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: REAR-END COLLISION, BOTHELL, WASHINGTON, FEBRUARY 17, 1998 PY - 2002/09/17 SP - 2 p. AB - On February 17, 1998, the driver of a tractor-double semitrailer stated that she noticed traffic on Interstate Highway 405 in Bothell, Washington, slowing in front of her and she began applying the brakes. She then noticed the air pressure for the brake system depleting rapidly. The tractor-double semitrailer subsequently rear-ended a van stopped in traffic ahead, pushing it into five other vehicles. The tractor-double semitrailer and van erupted in fire. Three van occupants were fatally injured; seven others involved in the collision sustained minor injuries. The U.S. Department of Transportation (DOT) conducted a compliance review in April 1991, giving the carrier an unsatisfactory rating for deficiencies in compliance with general regulations (Part 390), driver qualifications (Part 391), reporting of accidents (Part 394), and hours-of-service regulations (Part 391). DOT conducted another compliance review in 1992; the carrier received an overall satisfactory rating with a conditional rating for hours-of-service compliance. The National Transportation Safety Board determined that the probable cause of the accident was the inability of the truck driver to stop for traffic because of inoperable truck brakes. KW - Brakes KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Fatalities KW - Injuries KW - Multiple vehicle crashes KW - Rear end crashes KW - Safety audits KW - Safety violations KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers KW - Vehicle factors in crashes KW - Washington (State) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0214.pdf UR - https://trid.trb.org/view/643618 ER - TY - RPRT AN - 00943553 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: LOSS OF CONTROL ON DOWNGRADE, DUNLAP, TENNESSEE, AUGUST 13, 1998 PY - 2002/09/17 SP - 2 p. AB - This report describes an accident in which a tractor-semitrailer combination hauling wood chips lost control on a downgrade. The truck driver was unable to control the vehicle's speed traveling down a steep, 4-mile downgrade toward a signalized intersection at State Highway 111 and U.S. Highway 127. She stated that she attempted to downshift into a lower gear. The driver failed to put the transmission back into gear, thereby descending the hill with only air mechanical brakes to control the speed. She lost control of the truck, traveled into the intersection, and struck several parked and moving vehicles and pedestrians. Two occupants of a car were killed; four other vehicle occupants and 13 pedestrians were injured. The truck driver stated during her interview with the police that her truck was overloaded (in excess of 93,000 pounds). A postaccident inspection of the truck revealed no mechanical deficiencies. The Commercial Motor Vehicle Division of the Tennessee Department of Safety had never reviewed or audited either the owner/carrier of the truck tractor or the owner of the semitrailer involved in the accident. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's inability to control the truck on a long, steep downgrade. Contributing to the cause of the accident may have been excessive load weight. KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Downgrades (Roads) KW - Driver errors KW - Fatalities KW - Injuries KW - Loss of control KW - Multiple vehicle crashes KW - Overweight loads KW - Tennessee KW - Tractor trailer combinations KW - Truck crashes KW - Trucking safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0217.pdf UR - https://trid.trb.org/view/643621 ER - TY - RPRT AN - 00943551 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: HEAD-ON COLLISION, POLLOCKSVILLE, NORTH CAROLINA, MARCH 3, 1998 PY - 2002/09/17 SP - 2 p. AB - The accident described in this report involved a dump truck driver that crossed the centerline of U.S. Highway 17, a two-lane roadway, and struck a tractor-semitrailer head on. A witness stated that the dump truck driver moved over the centerline to avoid rear-ending a left-turning vehicle in front of it. Both trucks were destroyed, and both drivers were killed. The National Transportation Safety Board determined that the probable cause of the accident was the failure of the dump truck driver to stay in his travel lane. KW - Center lines KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Driver errors KW - Dump trucks KW - Fatalities KW - Frontal crashes KW - Judgment (Human characteristics) KW - North Carolina KW - Tractor trailer combinations KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0215.pdf UR - https://trid.trb.org/view/643619 ER - TY - RPRT AN - 00943552 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: COLLISION WITH SCHOOL BUS, CHAPPELL HILL, TEXAS, APRIL 7, 1998 PY - 2002/09/17 SP - 2 p. AB - On April 7, 1998, a car carrier was traveling east on U.S. Highway 290 in Chappell Hill, Texas, when the truck driver struck a stopped school bus on Nicholson Lake Road. The truck driver said that prior to the collision he braked and swerved to the left, but the right front of the truck struck the left rear of the school bus. Two students sustained serious injuries; 31 students, the bus driver, and the truck driver sustained minor injuries. Both vehicles were destroyed. The truck driver stated that he did not see the school bus because he was late and had been looking on his clipboard for a telephone number to call a business. He was placing his clipboard between the seats when he looked up and saw that the school bus was stopped. He had been awake for 14 1/2 hours and, except for a 45-minute nap, had been on duty for 13 1/4 hours and had been driving for almost 10 hours. By the time the driver would have completed his shift, he would have been awake for 18 hours, on duty for 15 hours, and driving for 12 hours. When asked how he felt, the driver stated that he was "physically tired" but believed that he was mentally alert. Texas has adopted most of the Federal Motor Carrier Safety Regulations with some variances. Pertinent to this accident are the variances for the hours-of-service and the record-keeping regulations. Texas allows intrastate drivers to drive 12 hours a day and does not require drivers to keep hours-of-service records. The carrier was rated satisfactory in July 1994. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's inattention to driving. Contributing to the accident may have been the truck driver's fatigue. KW - Attention lapses KW - Automobile carriers KW - Bus crashes KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Distraction KW - Fatigue (Physiological condition) KW - Hours of labor KW - Human factors in crashes KW - Injuries KW - Rear end crashes KW - Regulations KW - School buses KW - Texas KW - Truck crashes KW - Truck drivers KW - Trucking safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0216.pdf UR - https://trid.trb.org/view/643620 ER - TY - RPRT AN - 00943548 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: HIGHWAY-RAIL GRADE CROSSING COLLISION, GRANTSVILLE, UTAH, DECEMBER 3, 1997 PY - 2002/09/17 SP - 2 p. AB - In the highway-rail grade crossing accident reported in this brief, the driver of a tractor-double semitrailer combination stated that he saw the freight train when he was about 120 feet away from the passive grade crossings. He said that he believed he would jackknife the truck if he tried to stop and decided to accelerate in an attempt to get across the tracks before the train arrived. The train struck the right side of the first semitrailer. At impact, the first trailer detached from the tractor and severed into three pieces. The second trailer detached from the front trailer and wrapped around the front of the locomotive, rupturing the fuel tank of the locomotive. One train crewmember sustained minor injuries. The U.S. Department of Transportation performed a compliance review on July 12, 1984, giving the carrier an overall rating of satisfactory and a conditional rating for compliance with driver qualifications (Part 391). The Utah Department of Transportation performed reviews of the carrier in March 1994 and January 1995. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's poor judgment in attempting to cross the tracks before the train arrived. KW - Crash causes KW - Crash investigation KW - Crash reports KW - Crashes KW - Driver errors KW - Freight trains KW - Injuries KW - Judgment (Human characteristics) KW - Railroad crashes KW - Railroad grade crossings KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers KW - Utah UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0212.pdf UR - https://trid.trb.org/view/643616 ER - TY - RPRT AN - 00943547 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: COLLISION WITH JACKKNIFED SEMITRAILER, MENDOTA, CALIFORNIA, NOVEMBER 16, 1997 PY - 2002/09/17 SP - 2 p. AB - This report describes the collision of a passenger van with a tractor-semitrailer combination. A witness behind the van stated that the van's driver drove into the opposing lane of State Route 180 traffic at about 55 mph to pass two cars. The truck driver stated that he saw the van's headlights through the fog traveling toward him in his lane. He said he braked, skidded, and jackknifed into the opposing lane. The van struck the right side of the tractor. Eleven of the 12 van occupants were killed. The right-rear van passenger sustained serious injuries, and the truck driver sustained minor injuries. The carrier had been inspected under the California Highway Patrol's Biennial Inspection of Terminals Program in 1993, 1995, 1997, and 1999. In June 1997, the carrier received an unsatisfactory rating, mostly for hours-of-service violations and vehicle defects. In September 1997, the carrier was reinspected and given a satisfactory rating. The National Transportation Safety Board determined that the probable cause of the accident was the van driver's poor judgment in attempting to pass other vehicles in the fog. KW - California KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Crashes KW - Driver errors KW - Fatalities KW - Fog KW - Injuries KW - Jackknifing KW - Judgment (Human characteristics) KW - Multiple vehicle crashes KW - Passing KW - Passing sight distance KW - Tractor trailer combinations KW - Truck crashes KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0211.pdf UR - https://trid.trb.org/view/643615 ER - TY - RPRT AN - 00943549 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: HEAD-ON COLLISION, KILLEEN, TEXAS, JANUARY 10, 1998 PY - 2002/09/17 SP - 2 p. AB - On January 10, 1998, a Chevrolet Blazer sports utility vehicle (SUV) traveled across the centerline of the roadway on State Highway 195, and its left front struck the left front of a tractor-semitrailer. The SUV was destroyed, and the tractor was extensively damaged. The driver and four occupants of the SUV were fatally injured, and the truck driver sustained serious injuries. The SUV occupants had a significant blood alcohol content; the four passenger's levels measured 0.05, 0.10, 0.17, and 0.18 percent, and the driver's level was 0.09 percent. The level for being legally drunk at the time of the accident was 0.10 percent; now it is 0.08 percent. The National Transportation Safety Board determined that the probable cause of the accident was the failure of the sports utility vehicle driver to stay in his travel lane due to alcohol impairment. KW - Blood alcohol levels KW - Crash causes KW - Crash investigation KW - Crash reports KW - Drunk driving KW - Fatalities KW - Frontal crashes KW - Human factors in crashes KW - Injuries KW - Sport utility vehicles KW - Texas KW - Tractor trailer combinations UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0213.pdf UR - https://trid.trb.org/view/643617 ER - TY - RPRT AN - 00943545 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SINGLE VEHICLE RUN-OFF-THE ROAD AND VAULT, PINE BLUFF, ARKANSAS, OCTOBER 13, 1997 PY - 2002/09/17 SP - 2 p. AB - In the accident reported in this brief, the driver of an empty tractor-semitrailer combination ran off the left side of U.S. Highway 65 in Arkansas, struck a ditch embankment, vaulted, and came down on top of a stopped pickup truck in a private driveway. The pickup truck occupants were ejected and fatally injured. The driver of the Mack tractor-semitrailer was also fatally injured. His blood sample revealed a therapeutic dose of tramadol, a toothache pain medication, which can cause sleepiness, dizziness, and seizures. In 1991, the U.S. Department of Transportation conducted a safety review of the carrier and assigned a rating of unsatisfactory. No follow-up occurred. A Federal compliance review following the fatal accident revealed that the accident-involved carrier was in violation of many regulations: the carrier did not have a drug testing program, and it did not have the required driver qualification records, hours-of-service records, or maintenance records on file. The accident-involved truck driver did not have a medical certificate; whether he was medically fit to drive is not known. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's use of a prescription drug that may have caused him to become sleepy or incapacitated. KW - Arkansas KW - Compliance KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Drugged drivers KW - Fatalities KW - Human factors in crashes KW - Medication KW - Pickup trucks KW - Ran off road crashes KW - Safety audits KW - Single vehicle crashes KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers KW - Vault accidents UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0207.pdf UR - https://trid.trb.org/view/643613 ER - TY - RPRT AN - 00943546 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SIDESWIPE COLLISION WITH SCHOOL BUS, LANCASTER, OHIO, NOVEMBER 3, 1997 PY - 2002/09/17 SP - 2 p. AB - On November 3, 1997, the driver of a straight truck hauling produce entered an intersection on a red traffic signal and struck a school bus on its left side. Both vehicles rotated 90 degrees and came to rest within the intersection. The roadway was damp at the time of the accident. One of the 10 school bus occupants sustained serious injuries, 7 sustained minor injures, and 2 were uninjured. The truck driver sustained serious injuries. Postaccident testing revealed the presence of marijuana in the truck driver's system. Following the accident, the Public Utility Commission of Ohio conducted a compliance review of the carrier and found several violations regarding preemployment and random controlled-substance testing, employee checks, and hours of service. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's disregard for the red traffic signal, possibly due to drug impairment. KW - Bus crashes KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Driver errors KW - Drugged drivers KW - Human factors in crashes KW - Injuries KW - Marijuana KW - Ohio KW - Red light running KW - Safety audits KW - Safety violations KW - School buses KW - Side crashes KW - Truck crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0209.pdf UR - https://trid.trb.org/view/643614 ER - TY - RPRT AN - 00943542 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: HIGHWAY-RAIL GRADE CROSSING COLLISION, GARDEN CITY, GEORGIA, OCTOBER 9, 1997 PY - 2002/09/17 SP - 2 p. AB - A highway-rail grade crossing collision occurred between a truck with an empty lowbed semitrailer and a passenger train. The truck driver stated that as he approached the high-vertical profile (hump), passive railroad grade crossing, he noticed the hump but thought his truck could make it across. As he eased the truck across the track, according to the truck driver, he felt resistance but continued until the truck became stuck. The truck driver said that he immediately called 911 and reported his location and situation. Garden City police arrived at the crossing at 6:50 a.m. and notified the CSX Transportation (CSXT) dispatcher at 6:52 a.m. of the truck's location at the Hawkinsville Road crossing. The CSXT dispatcher was unable to locate the crossing and notify the train of the situation. At 7:12 a.m., an Amtrak train struck the lowbed semitrailer. One serious injury and 11 minor injuries resulted. The truck driver's license had been suspended, and he was in violation of the 70-hour rule. The truck driver tested positive for cocaine metabolites just after the accident. The motor carrier had never received a compliance review from the U.S. Department of Transportation or from Georgia. Following the accident, the Georgia Public Service Commission conducted a compliance review and found several deficiencies in record maintenance, preemployment checks, random drug testing, hours of service, and daily vehicle inspection reporting. The National Transportation Safety Board determined that the probable cause of the accident was the driver's poor judgment in traversing a hump grade crossing with a lowbed semitrailer. Contributing to the truck driver's poor judgment may have been impairment due to fatigue or withdrawal from cocaine, resulting in depression or fatigue. Also contributing to the accident was the failure of the CSXT dispatcher to locate the grade crossing and notify the train crew of the situation. KW - Amtrak KW - Cocaine KW - Crash causes KW - Crash investigation KW - CSX Transportation KW - Dispatchers KW - Driver errors KW - Drugged drivers KW - Emergency response time KW - Fatigue (Physiological condition) KW - Georgia KW - Grade crossing protection systems KW - Human factors in crashes KW - Injuries KW - Judgment (Human characteristics) KW - Passenger trains KW - Railroad crashes KW - Railroad grade crossings KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0206.pdf UR - https://trid.trb.org/view/643610 ER - TY - RPRT AN - 00943540 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: HIGHWAY-RAIL GRADE CROSSING COLLISION, BLUM, TEXAS, NOVEMBER 13, 1997 PY - 2002/09/17 SP - 2 p. AB - On November 13, 1997, the driver of a 1998 Ford tank truck hauling propane drove onto the railroad tracks at a passive grade crossing on Hill County Road 1130 in Blum, Texas, and was struck by a freight train. The propane tanks and the truck's fuel tank ruptured at impact, causing a fire. The truck driver and codriver were ejected and fatally injured. The truck driver had been taking prescription medicine for diabetes. The train's horn had been sounding; audibility testing revealed that it could not be heard in the truck cab. Sight distance was limited at this crossing; however, because the driver was hauling hazardous materials, he was required to stop, look, and listen for trains. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's failure to yield to the approaching freight train. KW - Crash causes KW - Driver errors KW - Fatalities KW - Fire KW - Freight trains KW - Fuel tanks KW - Hazardous materials KW - Horns KW - Human factors in crashes KW - Judgment (Human characteristics) KW - Perception KW - Railroad crashes KW - Railroad grade crossings KW - Tank trucks KW - Texas KW - Truck crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0210.pdf UR - https://trid.trb.org/view/643608 ER - TY - RPRT AN - 00943541 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: LOSS OF CONTROL ON DOWNGRADE, COLLISON OF LOAD WITH SCHOOL BUS, FRANKLIN, NORTH CAROLINA, OCTOBER 16, 1997 PY - 2002/09/17 SP - 2 p. AB - On October 16, 1997 in Franklin, North Carolina, a 1988 tractor-semitrailer hauling concrete telephone cable vaults was traveling downhill on the wrong side of U.S. Highway 64 on a curve when the load broke loose and struck a school bus. The tractor-semitrailer overturned and slid to a stop. The school bus driver and one passenger were killed; one passenger sustained moderate injuries. The truck driver and seven bus passengers sustained minor injuries. The school bus was destroyed and the tractor-semitrailer sustained moderate damage. Witnesses described the truck as traveling over the 35-mph speed limit and on the wrong side of the road just before the accident. The truck driver was arrested for driving under the influence of alcohol (a portable breath tester indicated that his blood alcohol level exceeded 0.10 percent). The truck driver had been convicted twice before of driving commercial vehicles while intoxicated. The carrier received a satisfactory rating following a Federal compliance review in January 1994. The National Transportation Safety Board determined that the probable cause of the accident was the truck driver's failure to control his truck due to alcohol impairment. KW - Crash causes KW - Crash investigation KW - Crash reports KW - Downgrades (Roads) KW - Driver errors KW - Drunk driving KW - Fatalities KW - Injuries KW - Loss of control KW - Multiple vehicle crashes KW - North Carolina KW - School buses KW - Speeding KW - Tractor trailer combinations KW - Traffic crashes KW - Truck crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0208.pdf UR - https://trid.trb.org/view/643609 ER - TY - RPRT AN - 00936795 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-22 PY - 2002/09/13 SP - 4 p. AB - This safety recommendation, addressed to spring brake manufacturers recommends that spring brake manufacturers develop a spring brake that allows inspectors or mechanics to view components safely to determine whether the spring brake is broken (H-02-22). KW - Brake components KW - Brakes KW - Inspectors KW - Mechanics (Persons) KW - Recommendations KW - Spring brakes KW - Springs (Vehicles) KW - Traffic safety KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_22.pdf UR - https://trid.trb.org/view/730052 ER - TY - RPRT AN - 00936792 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-19 PY - 2002/09/13 SP - 4 p. AB - This safety recommendation, addressed to the Honorable Jeffrey W. Runge, Administrator, National Highway Traffic Safety Administration, recommends that the National Highway Traffic Safety Administration obtain the authority, as necessary, and include propane fuel system integrity standards for aftermarket installations in the Federal Motor Vehicle Safety Standards (H-02-19). KW - After market KW - Federal Motor Vehicle Safety Standards KW - Fuel systems KW - Installation KW - Integrity KW - Propane KW - Recommendations KW - Standards KW - Traffic safety KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_19.pdf UR - https://trid.trb.org/view/730049 ER - TY - RPRT AN - 00936794 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-21 PY - 2002/09/13 SP - 4 p. AB - This safety recommendation, addressed to Mr. James M. Shannon, President and Chief Executive Officer, National Fire Protection Association recommends that the National Fire Protection Association amend National Fire Protection Association Standard 58, Storage and Handling of Liquefied Petroleum Gas, to require that (1) propane fuel systems installed in school buses be protected and (2) propane fuel systems meet the equivalent to Federal Motor Vehicle Safety Standard 301 crash protection standards (H-02-21). KW - Federal Motor Vehicle Safety Standards KW - Fuel systems KW - Handling and storage KW - Liquefied petroleum gas KW - Propane KW - Protection KW - Recommendations KW - School buses KW - Standards KW - Traffic crashes KW - Traffic safety KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_21.pdf UR - https://trid.trb.org/view/730051 ER - TY - RPRT AN - 00936791 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-15 THROUGH H-02-18 PY - 2002/09/13 SP - 6 p. AB - This safety recommendation, addressed to the Honorable Joseph M. Clapp, Administrator, Federal Motor Carrier Safety Administration, recommends that the Federal Motor Carrier Safety Administration: (1) revise 49 Code of Federal Regulations 396.13, Driver Inspection, to require minimum pretrip inspection procedures for determining brake adjustment (H-02-15); (2) require that vehicle inspections of a motor carrier's fleet be conducted during compliance reviews (H-02-16); (3) during compliance reviews, rate companies as unsatisfactory in the vehicle factor category if the mechanics and drivers responsible for maintaining brake systems are not qualified brake inspectors (H-02-17); and (4) revise 49 Code of Federal Regulations 396.25, Qualifications of Brake Inspectors, to require certification after testing as a prerequisite for qualification and specify, at a minimum, formal training in brake maintenance and inspection (H-02-18). KW - Brakes KW - Businesses KW - Certification KW - Compliance KW - Drivers KW - Federal government KW - Inspection KW - Inspectors KW - Maintenance KW - Motor carriers KW - Qualifications KW - Ratings KW - Recommendations KW - Regulations KW - Reviews KW - Traffic safety KW - Training KW - Truck drivers UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_15_18.pdf UR - https://trid.trb.org/view/730048 ER - TY - RPRT AN - 00936793 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-20 PY - 2002/09/13 SP - 3 p. AB - This safety recommendation, addressed to Mr. Stephen Campbell, Executive Director, Commercial Vehicle Safety Alliance, recommends that the Commercial Vehicle Safety Alliance include spring brake caging port dust covers as an inspection item during Motor Carrier Safety Assistance Program roadside inspections (H-02-20). KW - Brake components KW - Brakes KW - Inspection KW - Motor Carrier Safety Assistance Program KW - Motor carriers KW - Recommendations KW - Roadside KW - Spring brake caging port dust covers KW - Traffic safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_20.pdf UR - https://trid.trb.org/view/730050 ER - TY - RPRT AN - 00943435 AU - National Transportation Safety Board TI - SAFETY REPORT: TRANSPORTATION SAFETY DATABASES PY - 2002/09/11 SP - 78 p. AB - The National Transportation Safety Board relies on many external databases when performing accident investigations, safety studies, and special investigations. Most of these databases are sponsored and operated by the modal administrations of the U.S. Department of Transportation (DOT). The Board's ability to study important safety issues is often affected by poor data quality. The Board studied transportation safety databases to evaluate data quality issues and to encourage improvements in this area. The effort had four specific objectives: (a) highlight the value and potential uses of transportation safety data; (b) describe some accident and incident databases commonly used by the Board; (c) summarize past Board recommendations involving transportation data; and (d) evaluate Bureau of Transportation Statistics (BTS) efforts to establish data quality standards, identify information gaps, and ensure compatibility among the safety data systems maintained by the DOT. The Safety Board's past recommendations indicate that exposure data are not adequately detailed to support the analysis of risk factors for transportation accidents, reducing the ability of the Federal government to understand safety problems and target safety resources. BTS efforts to identify information gaps and to establish data quality standards are an important first step toward improving data quality. As a result of this finding, the Board issued a recommendation to the BTS to develop a long-term program to improve the collection of data describing exposure to transportation risk in the United States. KW - Compatibility KW - Crash exposure KW - Data quality KW - Databases KW - Improvements KW - Information gaps KW - Recommendations KW - Risk analysis KW - Standards KW - Transportation safety KW - U.S. Bureau of Transportation Statistics KW - United States UR - http://www.ntsb.gov/safety/safety-studies/Documents/SR0202.pdf UR - https://trid.trb.org/view/643514 ER - TY - RPRT AN - 00936892 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION BETWEEN TRUCK-TRACTOR SEMITRAILER AND SCHOOL BUS NEAR MOUNTAINBURG, ARKANSAS ON MAY 31, 2001 PY - 2002/09/04 SP - 69 p. AB - On May 31, 2001, near Mountainburg, Arkansas a Gayle Stuart Trucking, Inc., truck-tractor semitrailer collided with a 65-passenger school bus operated by the Mountainburg, Arkansas, Public Schools. Three school bus passengers were fatally injured; two other passengers received serious injuries. Four passengers, the school bus driver, and the truck driver sustained minor injuries. The major safety issues discussed in this report are the poor condition of the tractor semitrailer brakes, inadequate motor carrier inspections and oversight, and use of propane tanks on school buses, and occupant protection within school buses. As a result of its investigation, the Safety Board made recommendations to the Federal Motor Carrier Safety Administration, the National Highway Traffic Safety Administration, the Commercial Vehicle Safety Alliance, the National Fire Protection Association, and spring brake manufacturers. The Safety Board reiterated a recommendation to the U.S. Department of Transportation. KW - Arkansas KW - Brakes KW - Bus crashes KW - Fatalities KW - Highway safety KW - Injuries KW - Inspection KW - Motor carriers KW - Occupant protection devices KW - Oversight KW - Propane KW - Recommendations KW - School bus drivers KW - School bus passengers KW - School buses KW - School children KW - Tanks (Containers) KW - Tractor trailer combinations KW - Traffic crashes KW - Traffic safety KW - Truck crashes KW - Truck drivers UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0203.pdf UR - https://trid.trb.org/view/730132 ER - TY - RPRT AN - 00974051 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT BRIEF: EXECUTIVE AIRLINES, BRITISH AEROSPACE J-3101, N16EJ, BEAR CREEK TOWNSHIP, PENNSYLVANIA, MAY 21, 2000 PY - 2002/08/26 SP - 34 p. AB - On May 21, 2000, about 11:28 a.m., a British Aerospace Jetstream 3101, N16EJ, operated by East Coast Aviation Services (doing business as Executive Airlines) crashed about 11 miles south of Wilkes-Barre/Scranton International Airport (AVP), Wilkes-Barre, Pennsylvania. The airplane was destroyed by impact and a postcrash fire, and 17 passengers and two flight crewmembers were killed. The flight was being conducted as an on-demand charter flight. An instrument flight rules flight plan had been filed for the flight from Atlantic City International Airport to AVP. The National Transportation Safety Board determined that the probable cause of this accident was the flight crew's failure to ensure an adequate fuel supply for the flight, which led to the stoppage of the right engine due to fuel exhaustion and the intermittent stoppage of the left engine due to fuel starvation. Contributing to the accident were the flight crew's failure to monitor the airplane's fuel state and the flight crew's failure to maintain directional control after the initial engine stoppage. KW - Air transportation crashes KW - Charter operations KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Directional stability KW - Fatalities KW - Fuel consumption KW - Monitoring KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0205.pdf UR - https://trid.trb.org/view/697841 ER - TY - RPRT AN - 00943544 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SCHOOL BUS RUN-OFF-THE-ROAD AND ROLLOVER, NEAR GANADO, ARIZONA, NOVEMBER 3, 2000 PY - 2002/08/21 SP - 4 p. AB - On November 3, 2000, a school-activity bus carrying a driver and 37 passengers was traveling southbound on U.S. Route 191 in Arizona. The lanes of the highway were bordered by 2-foot-wide unpaved shoulders. The southbound shoulder had a 12-percent downgrade slope starting at the roadway edge. As the bus was entering a 744-foot-long, 2-degree left curve, the bus driver was distracted by a snack bag slipping off the dashboard. The bus's right front tire left the roadway and the driver steered to the right to avoid a post adjacent to the highway. The bus leaned to the right on the slope descending from the right side. As the bus inclined to the right, the driver's body slid and tilted to the right. As he tried to regain control, the driver's foot slipped and inadvertently pressed the accelerator pedal to full throttle. The bus driver stated that the shoulder was soft and steep and that the softness caused the bus to roll over. The bus traveled about 100 feet while overturning 1 l/4 turns. A chaperone and a student were partially ejected through broken windows on the right side and sustained fatal and serious injuries, respectively. Another student was seriously injured; the other occupants of the bus received minor injuries. Deformation of the bus interior was primarily confined to the roof and right side. The bus exterior sustained impact damage on the right side and the adjacent roof. On the left side, the most significant damage was below the floor area adjacent to the left-side emergency exit door. The rear emergency roof hatch was sheared off along the hinge line. The front emergency roof hatch was compressed downward, and the hinge was damaged along the hinge line and hatch frame. The National Transportation Safety Board determined that the probable cause of this accident was the driver's distraction, as he tried to prevent an object from falling off the dashboard. Contributing to the severity of the accident was the lack of a sufficient shoulder area adjacent to the roadway, which might have enabled the driver to recover control of the bus. KW - Arizona KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Distraction KW - Driver errors KW - Fatalities KW - Injuries KW - Ran off road crashes KW - Road shoulders KW - Rollover crashes KW - School bus drivers KW - School bus passengers KW - School buses KW - Single vehicle crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0205.pdf UR - https://trid.trb.org/view/643612 ER - TY - RPRT AN - 00943543 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SCHOOL BUS RUN-OFF-THE-ROAD AND ROLLOVER, HERNDON, KENTUCKY, NOVEMBER 30, 2000 PY - 2002/08/21 SP - 4 p. AB - On November 30, 2000, a school bus ran off the road on State Highway 117 near Herndon, Kentucky and overturned. The driver and 47 school children were on board. Just before the accident, the school bus was traveling north at a speed of 53 mph and was approaching a 3-degree left curve, when a student touched the driver's right arm. The bus driver said that as she looked to the right, the bus veered to the right and she turned the wheel to the left. The bus driver recalled that the student fell toward the boarding door step well and she tried to grab the child. The school bus traveled off the roadway at a 3- to 4-degree angle, hit a metal delineator, struck a corrugated metal drainage culvert, and rotated counterclockwise about its vertical axis on the east roadside. The bus reentered onto the pavement, continued rotating across the travel lanes, and overturned 180 degrees about its longitudinal axis. The bus continued rotating about its vertical axis; before coming to rest, the bus rolled back onto its right side. A mechanical inspection on scene showed that the steering, suspension, and tires were well maintained and the brakes were properly adjusted. During the rollover sequence, a 5-year-old student was fatally injured. The medical examiner determined that the victim sustained massive head trauma resulting from ejection through the front roof hatch opening. The busdriver and the other 46 students sustained minor injuries. The forward and rear roof emergency hatches were sheared off along the hinge line; the hatch openings remained intact. The National Transportation Safety Board determined that the probable cause of this accident was the school bus driver's failure to control the school bus after the bus driver had been distracted by one of the passengers. KW - Bus crashes KW - Crash causes KW - Crash investigation KW - Crash reports KW - Distraction KW - Driver errors KW - Emergency exits KW - Fatalities KW - Injuries KW - Kentucky KW - Ran off road crashes KW - Rollover crashes KW - School bus drivers KW - School bus passengers KW - School buses KW - Single vehicle crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0204.pdf UR - https://trid.trb.org/view/643611 ER - TY - RPRT AN - 00935895 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-08 PY - 2002/08/08 SP - 5 p. AB - This National Transportation Safety Board safety recommendation addressed to the Honorable Joseph M. Clapp, Administrator, Federal Motor Carrier Safety Administration recommends that the Federal Motor Carrier Safety Administration amend Code of Federal Regulations 383.51 (e), "Disqualification for railroad-highway grade crossing violation," to include a violation for drivers of low-clearance or slow-moving vehicles who fail to make arrangements with the railroad for safe passage, when required (H-02-08). KW - Railroad grade crossings KW - Railroad safety KW - Recommendations KW - Slow moving vehicles KW - Traffic safety KW - Traffic violations KW - Truck drivers KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_08.pdf UR - https://trid.trb.org/view/725575 ER - TY - RPRT AN - 00935896 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-09 THROUGH H-02-11 PY - 2002/08/08 SP - 6 p. AB - This National Transportation Safety Board safety recommendation addressed to Mr. John Horsley, Executive Director, American Association of State Highway and Transportation Officials recommends that American Association of State Highway and Transportation Officials encourage the states: (1) once the Uniform Vehicle Code, Section 11-703 has been revised to (a) adopt the revised Uniform Vehicle Code, Section 11-703, (b) include vehicle ground clearance as part of the permitting process, (c) require permitted slow-moving vehicles and those permitted vehicles that do not meet the ground-clearance provisions of the Uniform Vehicle Code to conduct route surveys (H-02-09); (2) once the Uniform Vehicle Code, Section 11-703 has been adopted, to include the text of the revised State statute on the face of permits (H-02-10); and (3) to conduct initial and recurrent training for state employees in the permit offices and state employees involved in commercial vehicle enforcement regarding the railroad notification requirements (H-02-11). KW - Commercial vehicles KW - Employees KW - Ground clearance (Vehicles) KW - Motor vehicles KW - Notification KW - Permits KW - Railroad safety KW - Recommendations KW - Routes KW - Slow moving vehicles KW - States KW - Surveys KW - Traffic law enforcement KW - Traffic safety KW - Training KW - U.S. National Transportation Safety Board KW - Uniform Vehicle Code UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_09_11.pdf UR - https://trid.trb.org/view/725576 ER - TY - RPRT AN - 00935894 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-07 PY - 2002/08/08 SP - 4 p. AB - This National Transportation Safety Board safety recommendation addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration and Ms. Leila Osina, Executive Director, National Committee on Uniform Traffic Laws and Ordinances recommends that the Federal Highway Administration and the National Committee on Uniform Traffic Laws and Ordinances revise Uniform Vehicle Code, Section 11-703, to define which vehicles, under what circumstances, need to notify the railroad before crossing a highway-rail grade crossing (H-02-07). KW - Motor vehicles KW - Railroad grade crossings KW - Railroad safety KW - Traffic safety KW - U.S. National Transportation Safety Board KW - Uniform Vehicle Code UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_07.pdf UR - https://trid.trb.org/view/725574 ER - TY - RPRT AN - 00935897 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-12 PY - 2002/08/08 SP - 4 p. AB - This National Transportation Safety Board safety recommendation addressed to all class I and regional railroads recommends that all class I and regional railroads provide easily accessed contact and notification information for use by vehicle operators requiring railroad assistance to ensure safety at grade crossings (H-02-12). KW - Class I railroads KW - Commercial vehicles KW - Information dissemination KW - Notification KW - Operators (Persons) KW - Railroad grade crossings KW - Railroad safety KW - Recommendations KW - Regional railroads KW - Traffic safety KW - Truck drivers KW - U.S. National Transportation Safety Board KW - Vehicle operations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_12.pdf UR - https://trid.trb.org/view/725577 ER - TY - RPRT AN - 00935898 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-13 AND H-02-14 PY - 2002/08/08 SP - 4 p. AB - This National Transportation Safety Board safety recommendation addressed to Mr. James C. Welsh, President and General Manager, Kissimmee Utility Authority (KUA) recommends that Kissimmee Utility Authority: (1) require that the CSX Transportation, Inc., railroad is notified in advance of accepting delivery by any low-clearance or slow-moving vehicles (H-02-13); and (2) install low-clearance highway-rail grade crossing signs (W 10-5s) at the KUA Power Road Crossing (H-02-14). KW - Delivery vehicles KW - Ground clearance (Vehicles) KW - Notification KW - Railroad grade crossings KW - Railroad safety KW - Recommendations KW - Signs KW - Slow moving vehicles KW - Traffic safety KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_13_14.pdf UR - https://trid.trb.org/view/725578 ER - TY - RPRT AN - 01014956 AU - National Transportation Safety Board TI - Pipeline Accident Report: Rupture of Piney Point Oil Pipeline and Release of Fuel Oil Near Chalk Point, Maryland, April 7, 2000 PY - 2002/07/23 SP - 62p AB - On the morning of April 7, 2000, the Piney Point Oil Pipeline system, which was owned by the Potomac Electric Power Company, experienced a pipe failure at the Chalk Point Generating Station in southeastern Prince George's County, Maryland. The release was not discovered and addressed by the contract operating company, Support Terminal Services, Inc., until the late afternoon. Approximately 140,400 gallons of fuel oil were released into the surrounding wetlands and Swanson Creek and, subsequently, the Patuxent River as a result of the accident. No injuries were caused by the accident, which cost approximately $71 million for environmental response and clean-up operations. The safety issues discussed in this report are the sufficiency of the evaluation procedures for pipe wrinkles; the efficiency of the leak notification procedures; and the effectiveness of the incident command. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the Research and Special Programs Administration and the Environmental Protection Agency. KW - Chalk Point (Maryland) KW - Costs KW - Effectiveness KW - Environmental impacts KW - Evaluation KW - Fuel oils KW - Leakage KW - Notification KW - Piney Point Oil Pipeline KW - Pipe wrinkles KW - Pipeline accidents KW - Pipeline failures KW - Pipeline safety KW - Potomac Electric Power Company KW - Procedures KW - Rivers KW - Rupture KW - Wetlands UR - https://www.ntsb.gov/doclib/reports/2002/PAR0201.pdf UR - https://trid.trb.org/view/771545 ER - TY - RPRT AN - 00933782 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION BETWEEN AMTRAK TRAIN 97 AND MOLNAR WORLDWIDE HEAVY HAUL COMPANY TRACTOR-TRAILER COMBINATION VEHICLE AT HIGHWAY-RAIL GRADE CROSSING IN INTERCESSION CITY, FLORIDA, ON NOVEMBER 17, 2000 PY - 2002/07/23 SP - 80 p. AB - On November 17, 2000, near Intercession City, Florida, a heavy-haul vehicle, operated by Molnar Worldwide Heavy Haul Company, was delivering a condenser to the Kissimmee Utility Authority Cane Island Power Plant. The private access road to the plant crossed over a single railroad track owned by CSX Transportation, Inc. As the vehicle crossed the tracks, the crossing warning devices activated and the gates came down on the load. Seconds later, Amtrak train 97 collided with the right side of the rear towed tractor. No injuries occurred. The collision destroyed the tractor and caused over $200,000 damage to the train and crossing signals. The following safety issues are discussed in this report: the ineffective execution of the roles and responsibilities of the power company and its contractors and subcontractors, the Florida Department of Transportation, the motor carrier, the truck driver, and pilot car drivers in planning and effecting the movement of this oversize load; the adequacy of the railroad notification requirement; the consistency and availability of information regarding railroad notification; and the lack of low-clearance warning signs and standard 1-800 emergency number signs. As a result of this accident investigation, the National Transportation Safety Board issued recommendations to the Federal Highway Administration, the Federal Motor Carrier Safety Administration, the American Association of State Highway and Transportation Officials, the National Committee on Uniform Traffic Laws & Ordinances, the Kissimmee Utility Authority, and all class I and regional railroads. KW - Access roads KW - Amtrak KW - Crash investigation KW - Gates KW - Low-clearance warning KW - Notification requirements KW - Oversize loads KW - Property damage KW - Railroad crashes KW - Railroad grade crossings KW - Recommendations KW - Tractor trailer combinations KW - Truck crashes KW - Warning devices UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0202.pdf UR - https://trid.trb.org/view/724879 ER - TY - RPRT AN - 01016460 AU - National Transportation Safety Board TI - Hazardous Materials Accident Report: Hazardous Materials Release From Railroad Tank Car With Subsequent Fire at Riverview, Michigan, July 14, 2001 PY - 2002/06/26 SP - 58p AB - About 3:45 a.m., eastern daylight time, on July 14, 2001, at the ATOFINA Chemicals, Inc., (ATOFINA) plant in Riverview, Michigan, a pipe attached to a fitting on the unloading line of a railroad tank car fractured and separated, causing the release of methyl mercaptan, a poisonous and flammable gas. About 4:09 a.m., shortly after the Riverview Fire Department chief arrived on scene, the methyl mercaptan ignited, engulfing the tank car in flames and sending a fireball about 200 feet into the air. Fire damage to cargo transfer hoses on an adjacent tank car resulted in the release of chlorine, a poisonous gas that is also an oxidizer. The fire was extinguished about 9:30 a.m. Three plant employees were killed in the accident. There were several other injuries; most of the injured were treated for respiratory symptoms and released. About 2,000 residents were evacuated from their homes for about 10 hours. Two tank cars, railroad track, and plant equipment (including hoses and fittings) were damaged in the fire. The major safety issues identified in this investigation are the adequacy of ATOFINA's procedures for unloading tank cars containing hazardous materials and the adequacy of Federal regulations and oversight for cargo transfer operations involving bulk containers transporting hazardous materials. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the U.S. Department of Transportation, the Federal Railroad Administration, the Environmental Protection Agency, and the Occupational Safety and Health Administration. KW - ATOFINA Chemicals, Incorporated KW - Bulk cargo KW - Cargo handling KW - Cargo transfer KW - Containers KW - Fatalities KW - Federal government KW - Fires KW - Flames KW - Flammable gases KW - Hazardous materials KW - Injuries KW - Loading and unloading KW - Methyl mercaptan KW - Oversight KW - Pipe KW - Poisonous gases KW - Procedures KW - Railroad cars KW - Railroad crashes KW - Railroad safety KW - Regulations KW - Riverview (Michigan) KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM0201.pdf UR - https://trid.trb.org/view/771679 ER - TY - RPRT AN - 00974052 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT BRIEF: SOUTHWEST AIRLINES FLIGHT 1455, BOEING 737-300, N668SW, BURBANK, CALIFORNIA, MARCH 5, 2000 PY - 2002/06/26 SP - 22 p. AB - On March 5, 2000, about 6:11 p.m., Southwest Airlines, Inc., flight 1455, a Boeing 737-300, overran the departure end of a runway after landing at Burbank-Glendale-Pasadena Airport, Burbank, California. The airplane touched down at approximately 182 knots, and about 20 seconds later, at approximately 32 knots, collided with a metal blast fence and an airport perimeter wall. The airplane came to rest on a street off of the airport property. Of the 142 persons on board, 2 passengers sustained serious injuries; 41 passengers and the captain sustained minor injuries; and the rest of the passengers and crew sustained no injuries. The airplane sustained extensive exterior damage and some internal damage to the passenger cabin. During the accident sequence, the forward service door escape slide inflated inside the airplane; the nose gear collapsed; and the forward dual flight attendant jumpseat, which was occupied by two flight attendants, partially collapsed. The flight was operating on an instrument flight rules flight plan. Visual meteorological conditions prevailed at the time of the accident, which occurred in twilight lighting conditions. The National Transportation Safety Board determines that the probable cause of this accident was the flight crew's excessive airspeed and flight path angle during the approach and landing and its failure to abort the approach when stabilized approach criteria were not met. Contributing to the accident was the controller's positioning of the airplane in such a manner as to leave no safe options for the flight crew other than a go-around maneuver. KW - Air transportation crashes KW - Airport runways KW - Airspeed KW - Approach control KW - Bob Hope Airport (Burbank, California) KW - California KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Flight paths KW - Injuries KW - Landing KW - Runway overruns KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0204.pdf UR - https://trid.trb.org/view/697842 ER - TY - RPRT AN - 00935867 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-02 AND H-02-03 PY - 2002/05/24 SP - 4 p. AB - This safety recommendation, addressed to Honorable Mary E. Peters, Administrator, Federal Highway Administration, recommends that the Federal Highway Administration (1) review and revise the Manual on Uniform Traffic Control Devices to provide guidance on coordination with law enforcement personnel used in traffic control strategies at highway work zones (H-02-02); and (2) in cooperation and consultation with the National Highway Traffic Safety Administration, the International Association of Chiefs of Police, the National Sheriffs' Association, and the American Association of State Highway and Transportation Officials, develop a model training program for law enforcement personnel that addresses traffic control strategies at highway work zones and encourage the States to adopt it. At a minimum, the training program should incorporate material from Part VI of the Manual on Uniform Traffic Control Devices and information concerning procedures and terminology typically used by highway engineers in establishing and evaluating work zone operations (H-02-03). KW - Highway engineers KW - Highways KW - Law enforcement personnel KW - Manual on Uniform Traffic Control Devices KW - Procedures KW - Recommendations KW - States KW - Strategic planning KW - Traffic law enforcement KW - Traffic safety KW - Training KW - U.S. National Transportation Safety Board KW - Work zone safety KW - Work zone traffic control UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_02_03.pdf UR - https://trid.trb.org/view/725543 ER - TY - RPRT AN - 00935868 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-04 PY - 2002/05/24 SP - 3 p. AB - This safety recommendation, addressed to Honorable Jeffrey W. Runge, Administrator, National Highway Traffic Safety Administration, recommends that the National Highway Traffic Safety Administration work with the Federal Highway Administration to develop a model training program for law enforcement personnel that addresses traffic control strategies at highway work zones. At a minimum, the training program should incorporate material from Part VI of the Manual on Uniform Traffic Control Devices and information concerning procedures and terminology typically used by highway engineers in establishing and evaluating work zone operations (H-02-04). KW - Highway engineers KW - Highways KW - Law enforcement personnel KW - Manual on Uniform Traffic Control Devices KW - Procedures KW - Recommendations KW - Strategic planning KW - Traffic safety KW - Training KW - U.S. National Transportation Safety Board KW - Work zone safety KW - Work zone traffic control UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_04.pdf UR - https://trid.trb.org/view/725544 ER - TY - RPRT AN - 00935869 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-05 PY - 2002/05/24 SP - 3 p. AB - This safety recommendation, addressed to Mr. J. Bruce Saltsman, Sr., Commissioner, Tennessee Department of Transportation, recommends that the Tennessee Department of Transportation conduct preconstruction conferences with all parties involved in a work zone project. As a result of such conferences, a written traffic control plan or project plan agreed to by all parties that defines the lines of authority and how traffic control and enforcement will be performed for all types of work zone configurations to be utilized will be produced (H-02-05). KW - Conferences KW - Line of authority KW - Planning KW - Recommendations KW - Tennessee KW - Traffic law enforcement KW - Traffic safety KW - U.S. National Transportation Safety Board KW - Work zone traffic control KW - Work zones KW - Written plan UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_05.pdf UR - https://trid.trb.org/view/725545 ER - TY - RPRT AN - 00935870 AU - National Transportation Safety Board TI - NATIONAL TRAFFIC SAFETY BOARD SAFETY RECOMMENDATION, H-02-06 PY - 2002/05/24 SP - 4 p. AB - This safety recommendation, addressed to Mr. Thomas N. Faust, Executive Director, National Sheriffs' Association; Mr. William B. Berger, President, International Association of Chiefs of Police; and Mr. John Horsely, Executive Director, American Association of State Highway and Transportation Officials recommends that the National Sheriffs' Association, the International Association of Chiefs of Police, and the American Association of State Highway and Transportation Officials work with the Federal Highway Administration to develop a model training program for law enforcement personnel that addresses highway work zone safety. At a minimum, the training program should incorporate material from Part VI of the Manual on Uniform Traffic Control Devices and information concerning procedures and terminology typically used by highway engineers in establishing and evaluating work zone operations (H-02-06). KW - Highway engineers KW - Highways KW - Law enforcement personnel KW - Manual on Uniform Traffic Control Devices KW - Procedures KW - Recommendations KW - Traffic safety KW - Training programs KW - U.S. National Transportation Safety Board KW - Work zone safety KW - Work zones UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_06.pdf UR - https://trid.trb.org/view/725546 ER - TY - RPRT AN - 00933783 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: WORK ZONE COLLISION BETWEEN A TRACTOR-SEMITRAILER AND A TENNESSEE HIGHWAY PATROL VEHICLE, JACKSON, TENNESSEE, JULY 26, 2000 PY - 2002/05/14 SP - 50 p. AB - About 8:52 a.m. on July 26, 2000, an eastbound 1999 International truck tractor pulling a loaded semitrailer, and traveling at a driver-estimated speed of 65 mph in a 55 mph work zone, collided with a Tennessee Highway Patrol (THP) vehicle trailing construction vehicles. Witnesses reported that the patrol car exploded and caught fire at impact. The patrol car was pushed approximately 192 feet before it came to rest in the median. The tractor-semitrailer continued through a 61-foot depressed earthen median and into the westbound lanes, where it collided with a 1997 Chevrolet Blazer. The tractor-semitrailer then continued across the travel lanes and came to rest in a wooded area on the north side of I-40. The State trooper in the THP vehicle was killed, and the Chevrolet driver was seriously injured. The following major safety issues were identified in this accident: lack of communication between the Tennessee Department of Transportation, its contractors, and the THP; inadequate planning and coordinating of traffic control responsibilities between highway construction personnel and law enforcement officers before engaging in work zone activities; and need to train officers in safe traffic control procedures within highway work zones. As a result of this accident investigation, the National Transportation Safety Board makes recommendations to the Federal Highway Administration, the National Highway Traffic Safety Administration, the Tennessee Department of Transportation, the National Sheriffs' Association, the International Association of Chiefs of Police, and the American Association of State Highway and Transportation Officials. KW - Communication KW - Construction and maintenance personnel KW - Construction management KW - Coordination KW - Crash investigation KW - Fatalities KW - Injuries KW - Law enforcement personnel KW - Police vehicles KW - Recommendations KW - Tractor trailer combinations KW - Training KW - Truck crashes KW - Work zone safety KW - Work zone traffic control KW - Work zones UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0201.pdf UR - https://trid.trb.org/view/724880 ER - TY - RPRT AN - 00943564 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SINGLE VEHICLE ROLLOVER, NEAR KARNACK, TEXAS, FEBRUARY 10, 2000 PY - 2002/05/09 SP - 4 p. AB - On February 10, 2000, a rented 15-passenger bus (van) carrying eight university student athletes and two athletic staff members was traveling north on Texas State Highway 43, a two-lane highway near Karnack, Texas. About 6:50 p.m., the van was traveling at approximately 82 mph in a posted 65-mph zone (nighttime) as it approached a northbound Jeep Cherokee that was signaling to turn left. The highway did not have a left turn lane, and the Jeep was in the northbound travel lane. The Jeep slowed while signaling to turn left, did not complete its left turn into the first entrance, remained in the northbound lane, and continued northbound. When the van driver attempted to pass the Jeep on the left from the southbound lane, the Jeep began its left turn into a second entrance. The van driver tried to reverse the passing action by swerving the van sharply to the right, and the van went out of control. The van yawed right, then left, dropped off the pavement edge, and rolled over three full turns before coming to rest inverted. The accident resulted in fatal injuries to the van driver and three of five ejected occupants. The remaining six passengers received serious injuries. Both front seat occupants were restrained, but no evidence of seat belt use was found at any of the rear seating positions. Texas statutes require that only adult occupants in the front seats be restrained. At the time of the accident, Prairie View A&M University did not have a written driving policy. A coach requesting a rental vehicle was responsible for the vehicle while it was in the university's possession. Student athletes have driven in the past, although it was not a customary practice. The National Transportation Safety Board determines that the probable cause of this accident was the excessive speed of the van, in combination with the operating maneuvers initiated by the van driver when he encountered the Jeep Cherokee; operating maneuvers by the Jeep Cherokee driver may also have been a factor. Contributing to the accident was the lack of oversight regarding the transportation of student athletes by the university. Contributing to the severity of the injuries was the state's failure to require the use of restraints in all seating positions and the failure of the van passengers to use the available restraints. KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Driver errors KW - Fatalities KW - Injuries KW - Left turns KW - Loss of control KW - Oversight KW - Policy KW - Prairie View A&M University KW - Rental cars KW - Restraint systems KW - Rollover crashes KW - Single vehicle crashes KW - Small buses KW - Speeding KW - Students KW - Texas KW - Two lane highways KW - Universities and colleges KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0203.pdf UR - https://trid.trb.org/view/643626 ER - TY - RPRT AN - 01104232 AU - National Transportation Safety Board TI - National Transportation Safety Board Railroad Accident Report: Derailment of Union Pacific Railroad Train in Eunice, Louisiana, on May 27, 2000 PY - 2002/05/02 SP - 50p AB - On Saturday, May 27, 2000, about 11:48 a.m. central daylight time, 33 of the 113 cars making up eastbound Union Pacific Railroad train QFPLI-26 derailed near Eunice, Louisiana. Of the derailed cars, 15 contained hazardous materials and 2 contained hazardous materials residue. The derailment resulted in a release of hazardous materials with explosions and fire. About 3,500 people were evacuated from the surrounding area, which included some of the business area of Eunice. No one was injured during the derailment of the train or the subsequent release of hazardous materials. Total damages exceeded $35 million. The major safety issues identified in this investigation are track conditions on the Union Pacific's Beaumont Subdivision and the effectiveness of the Union Pacific's track inspection activities, including management oversight. As a result of the investigation, the National Transportation Safety Board makes safety recommendations to the Federal Railroad Administration, the Union Pacific Railroad, and the Association of American Railroads. KW - Crash data KW - Crash investigation KW - Derailments KW - Explosions KW - Hazardous materials KW - Louisiana KW - Railroad crashes KW - Railroad safety KW - Railroad transportation KW - Union Pacific Railroad UR - http://ntl.bts.gov/lib/19000/19600/19695/PB2002916303.pdf UR - https://trid.trb.org/view/863968 ER - TY - RPRT AN - 00930112 AU - National Transportation Safety Board TI - MARINE ACCIDENT REPORT: SINKING OF THE AMPHIBIOUS PASSENGER VEHICLE MISS MAJESTIC, LAKE HAMILTON, NEAR HOT SPRINGS, ARKANSAS, MAY 1, 1999 PY - 2002/04/02 SP - 71 p. AB - This report discusses the sinking of the amphibious passenger vehicle Miss Majestic during an excursion tour of Lake Hamilton near Hot Springs, Arkansas, on May 1, 1999. Of the 21 people on board, 13 passengers, including 3 children, died. The vehicle damage was estimated at $100,000. The Safety Board's investigation of this accident identified safety issues in the following areas: vehicle maintenance, Coast Guard inspections of the Miss Majestic, Coast Guard inspection guidance, reserve buoyancy, and survivability. Based on its findings, the Safety Board made recommendations to the U.S. Coast Guard and the Governors of the States of New York and Wisconsin. Following this sinking accident, the Safety Board investigated two other accidents involving amphibious passenger vehicles, which are the subjects of brief reports published in an appendix of the Miss Majestic report. The first brief discusses the September 18, 2000 sinking of the Minnow, a 21-foot-long Alvis Stalwart-type amphibious passenger vehicle in the Milwaukee, Wisconsin harbor. No deaths or injuries resulted from this accident, and the vehicle damage was estimated at $170,000. The second brief discusses the December 8, 2001 sinking of the DUKW No. 1, a 33-fot-long amphibious passenger vehicle, in Lake Union, in Seattle, Washington. No deaths or injuries resulted from this accident, and the vehicle damage was estimated at $100,000. KW - Amphibious vehicles KW - Buoyancy KW - Fatalities KW - Hot Springs (Arkansas) KW - Inspection KW - Milwaukee (Wisconsin) KW - Passenger vehicles KW - Seattle (Washington) KW - Survival KW - Transportation safety KW - United States Coast Guard KW - Vehicle damage KW - Vehicle maintenance KW - Water transportation KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0201.pdf UR - https://trid.trb.org/view/719488 ER - TY - RPRT AN - 00929818 AU - National Transportation Safety Board TI - SAFETY REPORT: ANALYSIS OF INTRASTATE TRUCKING OPERATIONS PY - 2002/03/28 SP - 68 p. AB - Virtually all commercial trucks, drivers, and motor carriers are subject to safety regulations. Those operating in interstate commerce are subject to the Federal Motor Carrier Safety Regulations (FMCSR) and the hazardous material regulations as well as to state laws and regulations. The National Transportation Safety Board analyzed data from the Motor Carrier Management Information System, Trucks Involved in Fatal Accidents, U.S. roadside inspections, and other sources to describe the general characteristics of intrastate motor carriers, to identify intrastate carrier accident characteristics, and to compare these characteristics with accident involving interstate carriers. KW - Commercial vehicle operations KW - Crash characteristics KW - Crash investigation KW - Federal Motor Vehicle Safety Standards KW - Hazardous materials KW - Interstate transportation KW - Motor carriers KW - Regional transportation KW - Regulations KW - Safety KW - Trucks UR - https://app.ntsb.gov/doclib/safetystudies/SR0201.pdf UR - https://trid.trb.org/view/719355 ER - TY - RPRT AN - 01104256 AU - National Transportation Safety Board TI - National Transportation Safety Board Railroad Accident Report: Derailment of a CSX Transportation Coal Train V986-26 at Bloomington, Maryland, January 30, 2000 PY - 2002/03/05 SP - 50p AB - About 7:00 a.m. on January 30, 2000 eastbound loaded CSX Transportation coal train V986-26 lost effective braking while descending a section of track known as '17-mile grade' from Altamont to Bloomington, Maryland, and derailed 76 of its 80 'bathtub' high-side gondola cars when the train failed to negotiated curves at excessive speed. The derailed cars destroyed a nearby occupied residence, killing a 15-year-old boy and seriously injuring his mother. Three other occupants of the residence escaped with little or no injury. Track and equipment damages were estimated to be in excess of $3.2 million. There was no resulting fire or hazardous materials release. KW - Crash data KW - Crash reports KW - CSX Corporation KW - Derailments KW - Dynamic braking KW - Maryland KW - Railroad crashes KW - Railroad safety KW - Railroad transportation UR - http://ntl.bts.gov/lib/19000/19600/19694/PB2002916302.pdf UR - https://trid.trb.org/view/863966 ER - TY - RPRT AN - 00925890 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: 15-PASSENGER VAN MEDIAN CROSSOVER AND IMPACT WITH TRUCK, INTERSTATE 55 NEAR MILEPOST 250 IN WILL COUNTY, ILLINOIS, 6.5 MILES SOUTHWEST OF JOLIET, ILLINOIS, JANUARY 26, 2001 PY - 2002/02/22 SP - 5 p. AB - A 15-passenger van median crossover and impact with a truck occurred on Interstate 55 in Will County, Illinois, on January 26, 2001 at about 9:35 a.m. There were 11 fatalities (all in the van) and one minor injury (the truck driver). The National Transportation Safety Board determined that the probable cause of the accident was the van's loss of lateral stability when it encountered icy roadway conditions. Contributing to the loss of stability was the driver's failure to reduce his speed after passing several other accidents and slower moving traffic on the icy roadway surface. The driver's use of an over-the-counter antihistamine may have contributed to this operational error. KW - Antihistamines KW - Fatalities KW - Icy roads KW - Injuries KW - Interstate highways KW - Loss of control KW - Speed KW - Traffic crashes KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0202.pdf UR - https://trid.trb.org/view/718042 ER - TY - RPRT AN - 00943565 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SINGLE VEHICLE RUN-OFF-ROAD ROLLOVER, SAN MIGUEL, CALIFORNIA, JANUARY 2, 2001 PY - 2002/02/19 SP - 6 p. AB - On January 2, 2001 at 2:00 a.m., a bus driver with the West Valley Charter Lines, contracted to provide transportation for residential students at the California School for the Deaf, Fremont to and from their homes on weekends and holidays, began a circuitous route through central California, making several stops to pick up students. About 8:00 a.m., the bus entered U.S. 101 northbound. The bus driver set the cruise control at 70 mph. The driver stated that he had a limited recollection of events beyond that time. The accident occurred about 8:05 a.m. Physical evidence from the scene indicated that the bus departed the right side of the road, crossed the asphalt shoulder, and struck a guardrail. The bus then clipped the end of the concrete bridge rail and plunged about 23 feet to the roadway below. The bus rolled 270 degrees and yawed 180 degrees before coming to rest on its left side. Two passengers were ejected and were fatally injured. Two other passengers sustained serious injuries and one sustained minor injuries. The driver sustained minor injuries. The driver stated that on both December 30 and 31, 2000, he was off duty and awoke about 7:00 a.m. and went to bed about 11:00 p.m. On January 1, he awoke about 7:00 a.m., went to bed about 5:00 p.m. and got up about 11:00 p.m. He said his sleep was restful although sporadic. West Valley is registered with the California Highway Patrol as a School Pupil Activity Bus (SPAB). Nonconforming buses, such as the SPAB vehicle involved in this accident, meet the federal definition of a bus but are not required to meet the federal occupant crash protection standards for school buses. However, California allows the use of nonconforming buses for school activities or for transporting students to residential schools through the SPAB program. The National Transportation Safety Board determines that the probable cause of the accident was driver fatigue. Contributing to the accident was the transportation schedule established by the school, and a lack of knowledge by the driver of the effect of inverted sleep/rest cycles. Contributing to the severity of the injuries sustained in this accident was the use of a nonconforming bus for student transportation. KW - Bus crashes KW - Bus drivers KW - California KW - Crash causes KW - Crash diagrams KW - Crash investigation KW - Crash reports KW - Crashworthiness KW - Fatigue (Physiological condition) KW - Occupant protection devices KW - Passengers KW - Ran off road crashes KW - Rollover crashes KW - Single vehicle crashes KW - Sleep KW - Special purpose buses KW - Standards KW - Students KW - West Valley Charter Lines UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0201.pdf UR - https://trid.trb.org/view/643627 ER - TY - RPRT AN - 00925889 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SINGLE VEHICLE RUN-OFF-ROAD ROLLOVER, U.S. ROUTE 101, SAN MIGUEL, CALIFORNIA, JANUARY 2, 2001 PY - 2002/02/19 SP - 6 p. AB - A single vehicle run-off-road rollover accident occurred on U.S. Route 101, San Miguel, California, on January 2, 2001 at about 8:05 a.m. The vehicle involved was a 31-passenger bus attached to a Ford Motor Company F-550 XLT Super-Duty chassis manufactured with seating for a driver and a front-seat passenger. There were two fatalities, two serious injuries and two minor injuries. The National Transportation Safety Board determined that the probable cause of the accident was driver fatigue. Contributing to the accident was the transportation schedule established by the California School for the Deaf, Fremont, and a lack of knowledge by the driver of the effect of inverted sleep/rest cycles. Contributing to the severity of the injuries sustained in this accident was the use of a nonconforming bus for student transportation. KW - Bus drivers KW - Fatalities KW - Fatigue (Physiological condition) KW - Injuries KW - Ran off road crashes KW - Rollover crashes KW - School buses KW - Traffic crashes KW - Vehicle safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0201.pdf UR - https://trid.trb.org/view/718041 ER - TY - RPRT AN - 00925881 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, R-02-1 PY - 2002/02/15 SP - 3 p. AB - This safety recommendation, addressed to Mr. Allan Rutter, Administrator, Federal Railroad Administration (FRA), recommends that the FRA, for all railroads that install new or upgraded grade crossing warning systems that include crossing gates and that are equipped with event recorders, require that the information captured by those event recorders include the position of the deployed gates (R-02-1). KW - Crossing gates KW - Event recorders KW - Gate position KW - Railroad grade crossings KW - Recommendations KW - U.S. Federal Railroad Administration KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/R02_1.pdf UR - https://trid.trb.org/view/718032 ER - TY - RPRT AN - 00925883 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, R-02-2 PY - 2002/02/15 SP - 6 p. AB - This safety recommendation, addressed to all Class I and Regional Railroads (a list is attached), recommends that all Class I and Regional Railroads, for all their new and upgraded grade crossing warning systems that include crossing gates and that are equipped with event recorders, ensure that the information captured by those event recorders includes the position of the deployed gates (R-02-2). KW - Class I railroads KW - Crossing gates KW - Event recorders KW - Gate position KW - Railroad grade crossings KW - Recommendations KW - Regional railroads KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/R02_2.pdf UR - https://trid.trb.org/view/718034 ER - TY - RPRT AN - 00925882 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-02-1 PY - 2002/02/15 SP - 4 p. AB - This safety recommendation, addressed to the Honorable Norman Y. Mineta, Secretary of Transportation, recommends that the Department of Transportation provide Federal highway safety incentive grants to States to advance innovative pilot programs designed to increase enforcement of grade crossing traffic laws at both active and passive crossings (H-02-1). KW - Grant aid KW - Incentives KW - Railroad grade crossings KW - Recommendations KW - States KW - Traffic law enforcement KW - U.S. Department of Transportation UR - http://www.ntsb.gov/safety/safety-recs/recletters/H02_1.pdf UR - https://trid.trb.org/view/718033 ER - TY - RPRT AN - 00925884 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, R-02-3 PY - 2002/02/15 SP - 5 p. AB - This safety recommendation, addressed to Mr. George Warrington, President and Chief Executive Officer, National Railroad Passenger Corporation, recommends that the National Railroad Passenger Corporation, in fulfilling its Federal mandate to help prepare emergency responders to respond to an accident involving Amtrak equipment, emphasize to those responders the possibility that such an accident could result in large quantities of burning diesel fuel and urge them to be prepared to respond to this specific hazard (R-02-3). KW - Amtrak KW - Diesel fuels KW - Disaster preparedness KW - Fire KW - Hazards KW - Railroad crashes KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/R02_3.pdf UR - https://trid.trb.org/view/718035 ER - TY - RPRT AN - 00925885 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, R-02-4 PY - 2002/02/15 SP - 5 p. AB - This safety recommendation, addressed to Mr. Garry L. Briese, Executive Director, International Association of Fire Chiefs, and Mr. Harold A. Schaitberger, General President, International Association of Fire Fighters, recommends that the International Association of Fire Chiefs and the International Association of Fire Fighters inform their membership of the circumstances surrounding the grade crossing accident on March 15, 1999, in Bourbonnais, Illinois, and of the need for responders to prepare for train accidents that may result in significant diesel fuel fires (R-02-4). KW - Diesel fuels KW - Disaster preparedness KW - Fire KW - International Association of Fire Chiefs KW - International Association of Fire Fighters KW - Railroad crashes KW - Railroad grade crossings KW - Recommendations UR - http://ntl.bts.gov/lib/19000/19500/19523/PB2002107617.pdf UR - https://trid.trb.org/view/718036 ER - TY - RPRT AN - 00929767 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA. U.S. CARRIER OPERATIONS CALENDAR YEAR 1997 PY - 2002/01/24 SP - 77 p. AB - This report presents a statistical compilation and review of air carrier accidents that occurred in 1997 and that involved U.S.-registered aircraft conducting operations under Title 14 Code of Federal Regulations (CFR) Parts 121 and 135. The report applies to air carriers, such as major airlines and cargo haulers, and commuter airlines and on-demand air taxi operators. It provides an overview of accidents and their consequences, and several tables present accident parameters for 1997 and for the preceding years. Beginning with the 1998 Annual Review, presented will be annual statistics for commercial and general aviation in a revised format. KW - Air taxi service KW - Airlines KW - Aviation safety KW - Cargo aircraft KW - Commercial transportation KW - Commuter aircraft KW - Crash data UR - http://ntl.bts.gov/lib/17000/17000/17096/PB2000108038.pdf UR - http://ntl.bts.gov/lib/19000/19400/19425/PB2002106890.pdf UR - https://trid.trb.org/view/719317 ER - TY - RPRT AN - 00925876 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-47 PY - 2002/01/22 SP - 4 p. AB - This safety recommendation, addressed to a list of ten school bus manufacturers (distribution list included), recommends that school bus manufacturers discontinue the installation in school buses of radio speakers used for music or entertainment that are adjacent to the driver's head (H-01-47). The National Transportation Safety Board finds that, while information from the dispatcher is important, use of the radio speakers for music or entertainment broadcasts is not critical and can hamper the driver's ability to hear external auditory alerts. KW - Industries KW - Location KW - Noise control KW - Radio KW - Recommendations KW - School buses KW - Vehicle safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_47.pdf UR - https://trid.trb.org/view/718027 ER - TY - RPRT AN - 00925875 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-44 THROUGH -46 PY - 2002/01/22 SP - 10 p. AB - This safety recommendation, addressed to Mr. Charlie Gauthier, Executive Director, National Association of State Directors of Pupil Transportation Services (NASDPTS), recommends that the NASDPTS: Encourage its members to use the Federal Railroad Administration's Web-based accident prediction system or the States' hazard indexes for grade crossings when developing school bus routes (H-01-44); In cooperation with the States, develop and implement a program of initiatives for passive grade crossings and school buses that includes guidelines for stop sign installation and for use of active warning devices, a requirement for buses with noise-reducing switches, enhanced school bus driver training, and incorporation of questions on passive grade crossings in the commercial driver's license manual and examination (H-01-45); and Notify its members of how and why the school bus driver's lap/shoulder belt tore in the March 28, 2000 accident in Conasauga, Tennessee, and of the potential consequences of large longitudinal distances between lap/shoulder belt anchor points (H-01-46). KW - Commercial drivers KW - Driver licensing KW - Driver training KW - Manual safety belts KW - National Assoc of State Directors of Pupil Transp Services KW - Noise control KW - Railroad grade crossings KW - Recommendations KW - Routing KW - School bus drivers KW - School buses KW - Stop signs KW - Warning devices UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_44_46.pdf UR - https://trid.trb.org/view/718026 ER - TY - RPRT AN - 00925880 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-38 PY - 2002/01/22 SP - 11 p. AB - This safety recommendation, addressed to the State Governors and Mayor of the District of Columbia, recommends that the States, in cooperation with the National Association of State Directors of Pupil Transportation Services, develop and implement a program of initiatives for passive grade crossings and school buses that includes (1) installation of stop signs at passive crossings that are traversed by school buses except where an engineering study shows their installation would create a greater hazard; (2) use of information about whether school buses routinely cross passive grade crossings as a factor in selecting crossings to upgrade with active warning devices; (3) a requirement that all newly purchased and in-service school buses be equipped with noise-reducing switches; (4) enhanced school bus driver training and evaluation, including periodic reviews of on-board videotapes where available, especially with regard to driver performance at grade crossings; and (5) incorporation of questions on passive grade crossings in the commercial driver's license manual and examination (H-01-38). KW - Commercial drivers KW - Driver licensing KW - Driver training KW - Noise control KW - Railroad grade crossings KW - Recommendations KW - School bus drivers KW - School buses KW - States KW - Stop signs KW - Warning devices UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_38.pdf UR - https://trid.trb.org/view/718031 ER - TY - RPRT AN - 00925874 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-43 PY - 2002/01/22 SP - 4 p. AB - This safety recommendation, addressed to Mrs. Linda C. Schrenko, State Superintendent of Schools, Georgia Department of Education, recommends that the Georgia Department of Education require all school districts to disconnect radio speakers used for music or entertainment that are adjacent to school bus drivers' heads (H-01-43). A radio speaker adjacent to the driver's head masks exterior sounds, such as train horns, when it is being used for music or entertainment broadcasts. KW - Georgia Department of Education KW - Location KW - Noise control KW - Radio KW - Recommendations KW - School buses UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_43.pdf UR - https://trid.trb.org/view/718025 ER - TY - RPRT AN - 00925872 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-39 THROUGH -41 PY - 2002/01/22 SP - 5 p. AB - This safety recommendation, addressed to the Honorable Jeffrey W. Runge, Administrator, National Highway Traffic Safety Administration (NHTSA), recommends that NHTSA: implement rulemaking to prohibit radio speakers used for music or entertainment from being placed adjacent to drivers' heads in school buses (H-01-39); develop and incorporate into the Federal Motor Vehicle Safety Standards performance standards for school buses that address passenger protection for sidewalls, sidewall components, and seat frames (H-01-40); and evaluate the feasibility of incorporating automatic crash notification systems on school buses and, if feasible, proceed with system development (H-01-41). KW - Automatic crash notification KW - Crashworthiness KW - Energy absorbing materials KW - Federal Motor Vehicle Safety Standards KW - Location KW - Occupant vehicle interface KW - Radio KW - Recommendations KW - School buses KW - Seat frames KW - Sidewall components KW - Sidewalls KW - U.S. National Highway Traffic Safety Administration KW - Vehicle interiors KW - Vehicle padding UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_39_41.pdf UR - https://trid.trb.org/view/718023 ER - TY - RPRT AN - 00925873 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-42 PY - 2002/01/22 SP - 3 p. AB - This safety recommendation, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration (FHWA), recommends that the FHWA require States to update the Highway-Rail Crossing Inventory to accurately reflect current railroad operations (H-01-42). The States and others rely on this inventory for determining hazards and predicting accidents at grade crossings. Inaccurate information can lead to invalid assessments. KW - Accuracy KW - Highway Rail Crossing Inventory KW - Inventory KW - Railroad grade crossings KW - Railroad vehicle operations KW - Recommendations KW - U.S. Federal Highway Administration UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_42.pdf UR - https://trid.trb.org/view/718024 ER - TY - RPRT AN - 00942420 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT. IN-FLIGHT ELECTRICAL SYSTEM FAILURE AND LOSS OF CONTROL, JET EXPRESS SERVICES, RAYTHEON (BEECHCRAFT) SUPER KING AIR 200, N81PF, NEAR STRASBURG, COLORADO, JANUARY 27, 2001 PY - 2002/01/15 SP - 47 p. AB - This report explains the accident involving the Raytheon (Beechcraft) Super King Air 200, N81PF, owned by North Bay Charter, LLC, and operated by Jet Express Services. The aircraft crashed into rolling terrain near Strasburg, Colorado on January 27, 2001. The flight was operating on an instrument flight rules flight plan. The flight departed with two pilots and eight passengers aboard. The plan was transporting members of the Oklahoma State University basketball team and associated team personnel to Stillwater Regional Airport, Stillwater, Oklahoma, after a game at the University of Colorado at Boulder. All ten occupants aboard the flight were killed, and the airplane was destroyed by impact forces and a postcrash fire. Instrument meteorological conditions prevailed at the time of the accident. The probable cause of this accident was determined to be the pilot's spatial disorientation resulting from his failure to maintain positive manual control of the airplane with the available flight instrumentation. Contributing to the cause of the accident was the loss of alternating current electrical power during instrument meteorological conditions. The lack of oversight for athletic team and other college-sponsored travel is discussed. A safety recommendation concerning this issue is addressed to the National Collegiate Athletic Association, the National Association of Intercollegiate Athletics and the American Council on Education. KW - Air transportation crashes KW - Aircraft pilotage KW - Alternating current KW - Crash causes KW - Crash reports KW - Electric power KW - Human error KW - Human factors in crashes KW - Instrument flying KW - Jet Express Services KW - King Air aircraft KW - Oklahoma State University KW - Spatial disorientation KW - Strasburg (Colorado) KW - Universities and colleges UR - https://www.ntsb.gov/doclib/reports/2003/AAR0301.pdf UR - https://trid.trb.org/view/643155 ER - TY - RPRT AN - 00935885 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT BRIEF: SINGLE VEHICLE ROLLOVER, TEXAS STATE HIGHWAY 43, 1.5 MILES NORTH OF KARNACK, TEXAS, FEBRUARY 10, 2000 PY - 2002 SP - 4 p. AB - About 2:30 p.m. on February 10, 2000, a 1999 Ford E-350 XLT 15-passenger bus (van), rented from Enterprise Rent-A-Car, departed Prairie View A&M University near Hempstead, Texas. The van was carrying a track coach, an athletic trainer, and eight student athletes, enroute to a men's indoor track meet in Arkansas. A 21-year old student athlete was driving, and the van was traveling north on Texas State Highway 43, a two lane highway. At about 6:50 pm it attempted to pass a Jeep Cherokee that was signaling to make a left turn. The van was going about 82 mph in a 65 mph zone, at night. The van swerved to avoid the jeep and went out of control and rolled over. Four van occupants were killed and 6 were seriously injured. The National Transportation Safety Board determined that the probable cause of the accident was the excessive speed of the van, in combination with the operating maneuvers initiated by the van driver when he encountered the Jeep Cherokee; operating maneuvers by the Jeep Cherokee may also have been a factor. Contributing to the accident was the lack of oversight regarding the transportation of student athletes by the Prairie View A&M University. Contributing to the severity of the injuries were the failure of the state of Texas to require the use of restraints in all seating positions and the failure of the van passengers to use the available restraints. KW - Arkansas KW - College students KW - Drivers KW - Fatalities KW - Injuries KW - Jeep automobile KW - Left turns KW - Nighttime crashes KW - Oversight KW - Passing KW - Restraint systems KW - Rollover crashes KW - Speeding KW - Texas KW - Traffic crashes KW - Traffic safety KW - Vans UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAB0203.pdf UR - https://trid.trb.org/view/725564 ER - TY - RPRT AN - 00964875 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA. U.S. AIR CARRIER OPERATIONS CALENDAR YEAR 1999 PY - 2002 SP - 56 p. AB - This annual review presents a statistical compilation and review of accidents that occurred in 1999 involving aircraft operated by U.S. air carriers. In addition to providing accident statistics for 1999, the review also includes general economic and aviation indicators that may have influenced aircraft activity for 1999 as well as contextual accident data from several years preceding the reporting period. KW - Air transportation crashes KW - Annual reviews KW - Crash data KW - Economic indicators KW - Statistics UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARC03-01.pdf.old UR - https://trid.trb.org/view/661580 ER - TY - RPRT AN - 00963206 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT BRIEF: EGYPTAIR FLIGHT 990, BOEING 767-366ER, SU-GAP, 60 MILES SOUTH OF NANTUCKET, MASSACHUSETTS, OCTOBER 31, 1999 PY - 2002 SP - 43 p. AB - On October 31, 1999, about 0152 eastern standard time, EgyptAir Flight 990, a Boeing 767-366ER, SU-GAP, crashed into the Atlantic Ocean about 60 miles south of Nantucket, Massachusetts. The flight departed John F. Kennedy International Airport, New York, New York, en route to Cairo International Airport, Cairo, Egypt. All 217 people on board (203 passengers, 14 crew and flight team members) were killed and the airplane was destroyed. It is the conclusion of this report that the probable cause of the EgyptAir Flight 990 disaster is the airplane's departure from normal cruise flight and subsequent impact with the Atlantic Ocean as a result of the relief first officer's flight control inputs. The reason for the relief first officer's actions was not determined. KW - Aircraft pilotage KW - Airline pilots KW - Aviation safety KW - Crash analysis KW - Crash causes KW - Crash investigation KW - EgyptAir Flight 990 KW - Flight crews KW - General aviation KW - Human factors in crashes KW - Massachusetts UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0201.pdf UR - https://trid.trb.org/view/661054 ER - TY - RPRT AN - 00940590 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA. U.S. AIR CARRIER OPERATIONS CALENDAR YEAR 1998 PY - 2002 SP - 60 p. AB - This annual review presents a statistical compilation and review of accidents that occurred in 1998 involving aircraft operated by U.S. air carriers. While providing accident statistics for 1998, the review also includes general economic indicators that may influence aircraft activity for 1998 and contextual accident data from several years preceding this reporting period. KW - Annual reviews KW - Aviation safety KW - Crash analysis KW - Economic indicators KW - Freight and passenger services UR - http://libraryonline.erau.edu/online-full-text/ntsb/aircraft-accident-data/ARC02-02.pdf UR - https://trid.trb.org/view/731490 ER - TY - RPRT AN - 00932234 AU - National Transportation Safety Board TI - FIRE ON BOARD THE SMALL PASSENGER VESSEL PORT IMPERIAL MANHATTAN, HUDSON RIVER, NEW YORK CITY, NEW YORK, NOVEMBER 17, 2000. MARINE ACCIDENT REPORT NTSB/MAR-02/02. WASHINGTON, DC PY - 2002 SP - 52 p. AB - This report discusses the November 17, 2000, fire that occurred on the small passenger vessel Port Imperial Manhattan, while it was underway in the Hudson River from Manhattan to Weehawken, New Jersey. None of the 11 people on board the vessel was killed or sustained serious injury; however, a crewman and two passengers were transported to a shoreside hospital for medical evaluation. Damages related to the accident exceeded $1.2 million. From its investigation of this accident, the National Transportation Safety Board identified safety issues in the following areas: vessel maintenance; fire detection and suppression systems; crew response to the emergency; lifejacket stowage; safety information provided to passengers; and vessel communication. Based on its findings, the Safety Board made recommendations to the U.S. Coast Guard, the Federal Communications Commission, NY Waterway, and the Passenger Vessel Association. KW - Communication systems KW - Crash investigation KW - Emergency response time KW - Fire KW - Fire detection systems KW - Fire extinguishing agents KW - Hudson River KW - Life preservers KW - Maintenance KW - Marine safety KW - New York (New York) KW - Passenger information systems KW - Passenger ships KW - Weehawke (New Jersey) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0202.pdf UR - https://trid.trb.org/view/724396 ER - TY - RPRT AN - 00932387 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION OF NATIONAL RAILROAD PASSENGER CORPORATION (AMTRAK) TRAIN 59 WITH A LOADED TRUCK-SEMITRAILER COMBINATION AT A HIGHWAY/RAIL GRADE CROSSING IN BOURBONNAIS, ILLINOIS, MARCH 15, 1999 PY - 2002 SP - 77 p. AB - About 9:47 p.m. on March 15, 1999, National Railroad Passenger Corporation (Amtrak) train 59, with 207 passengers and 21 Amtrak or other railroad employees on board and operating on Illinois Central Railroad (IC) main line tracks, struck and destroyed the loaded trailer of a tractor-semitrailer combination that was traversing the McKnight Road grade crossing in Bourbonnais, Illinois. Both locomotives and 11 of the 14 cars in the Amtrak consist derailed. The derailed Amtrak cars struck 2 of 10 freight cars that were standing on an adjacent siding. The accident resulted in 11 deaths and 122 people being transported to local hospitals. Total Amtrak equipment damages were estimated at $14 million, and damages to track and associated structures were estimated to be about $295,000. The safety issues discussed in this report are as follows: truck driver performance, emergency response, and signal system performance. As a result of this investigation, the Safety Board makes safety recommendations to the U.S. Department of Transportation, the Federal Railroad Administration, all class I and regional railroads, Amtrak, the International Association of Fire Fighters, and the International Association of Fire Chiefs. KW - Amtrak KW - Derailments KW - Emergency response time KW - Fatalities KW - Illinois KW - Injuries KW - Performance KW - Railroad crashes KW - Railroad grade crossings KW - Railroad safety KW - Railroad tracks KW - Signal devices KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers KW - Trucking safety UR - http://ntl.bts.gov/lib/19000/19600/19693/PB2002916301.pdf UR - https://trid.trb.org/view/724458 ER - TY - RPRT AN - 00925864 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-30, -31, AND -34 PY - 2001/12/20 SP - 5 p. AB - This safety recommendation, addressed to the Honorable Mary E. Peters, Administrator, Federal Highway Administration, recommends that the Federal Highway Administration: (1) Develop a model pilot car driver training program (H-01-30); (2) Develop model oversize/overweight vehicle movement guidelines (H-01-31); and (3) Encourage the States to adopt the model oversize/overweight vehicle movement guidelines, as addressed in Safety Recommendations H-01-31 and -33, and once developed, to require that oversize/overweight vehicle movements conform to the guidelines (H-01-34). KW - Driver training KW - Guidelines KW - Oversize loads KW - Oversize vehicles KW - Overweight loads KW - Pilot car operators KW - Pilot cars KW - Police escorts KW - Recommendations KW - Truck drivers KW - U.S. Federal Highway Administration UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_30_31_34.pdf UR - https://trid.trb.org/view/718013 ER - TY - RPRT AN - 00925866 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-35 PY - 2001/12/20 SP - 4 p. AB - This safety recommendation, addressed to the Honorable Gus Gomez, Mayor of Glendale, California, recommends that the city of Glendale, California, install low-clearance highway-railroad grade crossing signs (W10-5s) at the Grandview Avenue crossing and evaluate other crossings to determine whether the signs are warranted and, if so, install them (H-01-35). KW - Glendale (California) KW - Low-clearance signs KW - Railroad grade crossings KW - Recommendations KW - Warning signs KW - Warrants (Traffic control devices) UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_35.pdf UR - https://trid.trb.org/view/718015 ER - TY - RPRT AN - 00925868 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-32 AND -33 PY - 2001/12/20 SP - 6 p. AB - This safety recommendation, addressed to Ms. Linda Lewis, President and Chief Executive Officer, American Association of Motor Vehicle Administrators (AAMVA), Ms. Barbara Payne, President, California Professional Escort Car Association, Mr. Jake Kimmell, President, Texas Pilot Car Association, and Mr. Billy Bob Bruhns, President, United Safety Car Association, recommends that the AAMVA, the California Professional Escort Car Association, the Texas Pilot Car Association, and the United Safety Car Association work with the Federal Highway Administration (FHWA) to develop a model pilot car driver training program (H-01-32) and work with the FHWA to develop model oversize/overweight vehicle movement guidelines (H-01-33). KW - American Association of Motor Vehicle Administrators KW - California Professional Escort Car Association KW - Driver training KW - Guidelines KW - Oversize loads KW - Oversize vehicles KW - Overweight loads KW - Pilot car operators KW - Pilot cars KW - Police escorts KW - Recommendations KW - Texas Pilot Car Association KW - U.S. Federal Highway Administration KW - United Safety Car Association UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_32_33.pdf UR - https://trid.trb.org/view/718017 ER - TY - RPRT AN - 00925865 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-32, -33, AND -37 PY - 2001/12/20 SP - 8 p. AB - This safety recommendation, addressed to Mr. Joel M. Dandrea, Executive Vice President, Specialized Carriers and Rigging Association, recommends that the Specialized Carriers and Rigging Association: (1) Work with the Federal Highway Administration (FHWA) to develop a model pilot car driver training program (H-01-32); (2) Work with the FHWA to develop model oversize/overweight vehicle movement guidelines (H-01-33); and (3) Notify its members of the circumstances of the Glendale, California, accident and, during in-service training for heavy-haul drivers, (1) highlight the potential hazards associated with moving low-clearance trailers over grade crossings and (2) emphasize the need to notify the railroads before an oversize/overweight vehicle is escorted across a highway/rail grade crossing (H-01-37). KW - Driver training KW - Guidelines KW - Low-clearance vehicles KW - Oversize loads KW - Oversize vehicles KW - Overweight loads KW - Pilot car operators KW - Pilot cars KW - Railroad grade crossings KW - Recommendations KW - Specialized Carriers and Rigging Association KW - Truck drivers KW - U.S. Federal Highway Administration UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_32_33_37.pdf UR - https://trid.trb.org/view/718014 ER - TY - RPRT AN - 00925867 AU - Blakey, M C AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-36 PY - 2001/12/20 SP - 3 p. AB - This safety recommendation, addressed to Mr. Bruce D. Glasscock, President, International Association of Chiefs of Police, and Mr. Thomas N. Faust, Executive Director, National Sheriffs' Association, recommends that the International Association of Chiefs of Police and the National Sheriffs' Association notify their members of the circumstances of the Glendale, California, accident and encourage them to train their officers to make sure (1) that documentation regarding permits is reviewed and verified; (2) that safety briefings to discuss routings and special conditions, including the hazards associated with moving oversize/overweight vehicles over grade crossings, are conducted; (3) that provisions for handling off-route loads are in place; and (4) that necessary notification to the railroads is made before an oversize/overweight vehicle is escorted across a highway/rail grade crossing (H-01-36). KW - Glendale (California) KW - International Association of Chiefs of Police KW - National Sheriffs' Association KW - Notifications KW - Oversize loads KW - Oversize vehicles KW - Overweight loads KW - Permits KW - Police KW - Police escorts KW - Railroad grade crossings KW - Recommendations KW - Safety briefings KW - Traffic crashes KW - Training UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_36.pdf UR - https://trid.trb.org/view/718016 ER - TY - RPRT AN - 00921861 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION OF CSXT FREIGHT TRAIN AND MURRAY COUNTY SCHOOL DISTRICT SCHOOL BUS AT RAILROAD/HIGHWAY GRADE CROSSING CONASAUGA, TENNESSEE, MARCH 28, 2000 PY - 2001/12/11 SP - 73 p. AB - On March 28, 2000, about 6:40 a.m. (sunrise was at 6:33 a.m.), a CSXT Transportation, Inc., freight train traveling 51 mph struck the passenger side of a Murray County, Georgia, School District school bus at a railroad/highway grade crossing near Conasauga, Tennessee. The accident occurred as the school bus was crossing the tracks at a speed of approximately 15 mph. During the accident sequence, the driver and three children were ejected. Two ejected passengers received serious injuries and one was fatally injured. The driver, who had been wearing a lap/shoulder belt that broke during the crash sequence, received minor injuries. Of the four passengers who remained inside the bus, two were fatally injured, one sustained serious injuries, and one, who was restrained by a lap belt, received minor injuries. The two train crewmembers were not injured. The following major safety issues were identified in this accident: the bus driver's performance; school district oversight, including bus driver monitoring and evaluation procedures and bus routing; passive grade crossing safety, including previous initiatives related to passive grade crossing and school bus safety; and occupant kinematics and survival factors. As a result of this accident investigation, the National Transportation Safety Board makes recommendations to the States, the National Highway Traffic Safety Administration, the Federal Highway Administration, the Georgia Department of Education, the National Association of State Directors of Pupil Transportation Services, and the school bus manufacturers. The Safety Board also reiterates a recommendation to the U.S. Department of Transportation. KW - At grade intersections KW - Children KW - Ejection KW - Evaluation KW - Fatalities KW - Freight trains KW - Georgia KW - Highway safety KW - Injuries KW - Kinematics KW - Monitoring KW - Oversight KW - Performance KW - Railroad crashes KW - Railroad grade crossings KW - Routing KW - School bus drivers KW - School bus passengers KW - School buses KW - School districts KW - Seat belts KW - Survival KW - Tennessee KW - Traffic crashes KW - Traffic safety KW - Vehicle occupants UR - http://ntl.bts.gov/lib/18000/18400/18435/PB2001916203.pdf UR - https://trid.trb.org/view/706882 ER - TY - RPRT AN - 00921860 AU - National Transportation Safety Board TI - RAILROAD INVESTIGATION REPORT: MARYLAND TRANSIT ADMINISTRATION LIGHT RAIL VEHICLE ACCIDENTS AT THE BALTIMORE-WASHINGTON INTERNATIONAL AIRPORT TRANSIT STATION NEAR BALTIMORE, MARYLAND FEBRUARY 13 AND AUGUST 15, 2000 PY - 2001/12/11 SP - 80 p. AB - In 2000, the Maryland Transit administration experienced two similar accidents in the same location just 6 months apart. Both accidents involved the failure of a light rail vehicle train to stop at the designated stopping point at the Baltimore-Washington International Airport Light Rail Station (BWI Airport Station). The Safety Board's investigation of the two accidents indicated that, although the direct cause of each accident was different, aspects of the Maryland Transit Administration rail transit operation common to the two accidents influenced both their outcomes. The first accident occurred about 2:37 p.m. on February 13, 2000, when Maryland Transit Administration train 24, en route from Baltimore to the BWI Airport, struck the hydraulic bumping post at the terminus of track No. 1 at the BWI Airport Station and derailed. The second accident occurred about 7:14 a.m. on August 15, 2000, when Maryland Transit Administration train 22, en route from Baltimore to the BWI Airport, struck the hydraulic bumping post at the terminus of track No. 2 at the BWI Airport Station and derailed. The safety issues discussed in this report are the adequacy of requirements governing the use of prescription and over-the-counter medications by light rail vehicle operators, the effect of sleeping disorders on the performance of light rail vehicle operators, and the adequacy of the event recorders. As a result of its investigation, the Safety Board issued safety recommendations to the Federal Transit Administration, U.S. rail transit systems, and the Maryland Transit Administration. KW - Baltimore (Maryland) KW - Derailments KW - Event recorders KW - Light rail transit KW - Light rail vehicles KW - Maryland Transit Administration KW - Medication KW - Rail transit stations KW - Railroad crashes KW - Railroad safety KW - Sleep disorders KW - Transit crashes KW - Transit operators KW - Transit safety KW - U.S. Federal Transit Administration UR - http://ntl.bts.gov/lib/11000/11700/11786/SIR0102.pdf UR - https://trid.trb.org/view/706881 ER - TY - RPRT AN - 01104260 AU - National Transportation Safety Board TI - National Transportation Safety Board Railroad Accident Report: Rear-End Collision of National Railroad Passenger Corporation (AMTRAK) Train P286 with CSXT Freight Train Q620 on the CSX Railroad at Syracuse, New York, on February 5, 2001 PY - 2001/11/27 SP - 46p AB - At about 11:40 a.m., eastern standard time, on February 5, 2001, eastbound Amtrak train 286, with 100 passengers and 4 crewmembers, struck the rear of eastbound CSX Transportation (CSXT) freight train Q620 on the CSXT Railroad near Syracuse, New York. On impact, the lead Amtrak locomotive unit and four of the train's five cars derailed. The rear truck of the last car of the 92-car CSXT freight train derailed, and the car lost a portion of its load of lumber. At the time of impact, the passenger train was traveling 35 mph; the freight train was traveling 7 mph. The accident resulted in injuries to all 4 crewmembers and 58 of the passengers aboard the Amtrak train. No CSXT crewmember was injured. A small amount of diesel fuel spilled from the fuel tank on the lead Amtrak locomotive unit, but no fire resulted. Total damages were estimated to be about $280,600. The safety issues addressed in the report are the lack of a positive train control system to prevent train collisions, the adequacy of Amtrak's procedures for ensuring that appliances on Amtrak trains are always properly secured, and the adequacy of maps used by emergency response personnel for railroad accidents. As a result of this accident investigation, the Safety Board made recommendations to the Federal Railroad Administration, the National Emergency Number Association, the Association of American Railroads, the American Short Line and Regional Railroad Association, and the National Railroad Passenger Corporation. KW - Crash injuries KW - Crashes KW - Disaster preparedness KW - Emergency transportation KW - Freight transportation KW - Railroad crashes KW - Railroad safety KW - Rear end crashes KW - Safety and security UR - http://ntl.bts.gov/lib/18000/18400/18437/PB2001916304.pdf UR - https://trid.trb.org/view/863969 ER - TY - RPRT AN - 00921854 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION BETWEEN METROLINK TRAIN 901 AND MERCURY TRANSPORTATION, INC., TRACTOR-COMBINATION VEHICLE AT HIGHWAY RAILROAD GRADE CROSSING IN GLENDALE, CALIFORNIA ON JANUARY 28, 2000 PY - 2001/11/27 SP - 69 p. AB - About 5:56 a.m. on January 28, 2000, in Glendale, California, a tractor-combination vehicle was transporting an oil refinery condenser unit. The vehicle was attempting to traverse a highway-railroad grade crossing when it became lodged on the railroad tracks. A northbound commuter train collided with the vehicle. The engineer, conductor, and four passengers received minor injuries. Total damages were estimated to be over $2 million. The major safety issues discussed in this report were the appropriateness of the actions of the truck driver, pilot car drivers, and police escorts; the weaknesses in the planning, coordination, and execution of this oversize/overweight movement; pilot car driver and truck driver fatigue; and the lack of low-clearance warning signs. As a result of this accident investigation, the National Transportation Safety Board issued recommendations to the Federal Highway Administration; Federal Motor Carrier Safety Administration; city of Glendale, California; American Association of State Highway and Transportation Officials; American Association of Motor Vehicle Administrators; Commercial Vehicle Safety Alliance; International Association of Chiefs of Police; National Sheriffs' Association; Specialized Carriers and Rigging Association; California Professional Escort Car Association; Texas Pilot Car Association; and United Safety Car Association. KW - At grade intersections KW - Combination carriers KW - Condensers KW - Coordination KW - Escort service KW - Fatigue (Physiological condition) KW - Glendale (California) KW - Highway safety KW - Implementation KW - Injuries KW - Low clearance (Trucks) KW - Oil refineries KW - Oversize loads KW - Pilot car drivers KW - Pilot cars KW - Planning KW - Police KW - Railroad commuter service KW - Railroad crashes KW - Railroad grade crossings KW - Railroad tracks KW - Traffic crashes KW - Traffic safety KW - Truck crashes KW - Truck drivers KW - Truck tractors KW - Trucking safety KW - Warning signs UR - http://ntl.bts.gov/lib/18000/18400/18434/PB2001916202.pdf UR - http://ntl.bts.gov/lib/18000/18400/18434/PB2001916202.pdf UR - https://trid.trb.org/view/706875 ER - TY - RPRT AN - 00921862 AU - National Transportation Safety Board TI - SAFETY STUDY: PUBLIC AIRCRAFT SAFETY PY - 2001/10/23 SP - 55 p. AB - "Public aircraft" are aircraft operated for the purpose of fulfilling a government function that meet certain conditions specified under Title 49 United States Code, Section 40102(a)(37). The Safety Board identified 341 public aircraft accidents that occurred during the years 1993-2000. Using activity data from the Federal Aviation Administration (FAA) (for the period 1996-1999), the Board calculated an accident rate of 3.66 accidents per 100,000 flight hours for nonmilitary, nonintelligence public aircraft. Using activity data from the General Services Administration (also for the period 1996-1999), the Board calculated an accident rate of 4.58 per 100,000 flight hours for nonmilitary, nonintelligence Federal aircraft. Both rates were lower than the general aviation accident rate (7.2 accidents per 100,000 flight hours), but higher than the accident rate for air taxis (3.47), scheduled Part 14 CFR 135 operations (1.06), or 14 CFR Part 121 operations (0.30). Comparisons between public and general aviation accidents revealed similar proportions of broad causal factors. However, accidents in these two sectors differed in other ways. A higher proportion of public aircraft crashed during local flights, at off-airport locations, and during maneuvering phases of flight. Also, accident-involved public aircraft pilots were more likely than accident-involved general aviation pilots to hold advanced ratings. Limitations and flaws associated with the FAA's nonairline activity estimates made it impossible for the Board to make carefully controlled comparisons of the safety of public versus civil aircraft. The data were not sufficiently detailed to support the calculation of public and civil aircraft accident rates for specific purposes of flight (for example, aerial observation, aerial application, and so on). Furthermore, FAA flight hour estimates are potentially biased because they are based on a survey that is administered to a sample of aircraft owners listed in the FAA's Civil Aircraft Registry, which is known to contain many outdated or inaccurate records. As a result of these findings, the Board made safety recommendations to the Federal Aviation Administration and the General Services Administration. KW - Accuracy KW - Air pilots KW - Air transportation crashes KW - Aircraft KW - Civil aircraft KW - Crash data KW - Crash rates KW - General aviation KW - General aviation pilots KW - Public aircraft KW - Public aircraft pilots KW - Recordkeeping KW - Safety KW - U.S. Federal Aviation Administration KW - U.S. General Services Administration UR - http://app.ntsb.gov/doclib/safetystudies/SS0101.pdf UR - https://trid.trb.org/view/706883 ER - TY - RPRT AN - 00822792 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY OVERRUN DURING LANDING, AMERICAN AIRLINES FLIGHT 1420, MCDONNELL DOUGLAS MD-82, N215AA, LITTLE ROCK, ARKANSAS, JUNE 1, 1999 PY - 2001/10/23 SP - 228 p. AB - This report explains the accident involving American Airlines flight 1420, a McDonnell Douglas MD-82, which crashed after it overran the end of runway 4R during landing at Little Rock National Airport in Little Rock, Arkansas. Safety issues discussed in this report focus on flight crew performance, flight crew decision-making regarding operations in adverse weather, pilot fatigue, weather information dissemination, emergency response, frangibility of airport structures, and Federal Aviation Administration (FAA) oversight. Safety recommendations concerning these issues are addressed to the FAA and the National Weather Service. KW - Air pilots KW - Air transportation crashes KW - Airport runways KW - Airport structures KW - American Airlines, Inc. KW - Decision making KW - Emergency response KW - Fatalities KW - Fatigue (Physiological condition) KW - Flight crews KW - Injuries KW - Landing KW - Little Rock (Arkansas) KW - Little Rock National Airport KW - McDonnell Douglas aircraft KW - McDonnell Douglas MD-82 KW - Oversight KW - Personnel performance KW - Recommendations KW - Runway overruns KW - U.S. Federal Aviation Administration KW - U.S. National Weather Service KW - Weather conditions KW - Weather information systems UR - http://ntl.bts.gov/lib/14000/14500/14520/ADA397810.pdf UR - https://trid.trb.org/view/713244 ER - TY - RPRT AN - 01144480 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Collision with Terrain of Big Island Air flight 58, near Volcano, Hawaii, September 25, 1999 PY - 2001/09/26 SP - 12p AB - On September 25, 1999, about 1726 Hawaiian standard time, Big Island Air flight 58, a Piper PA-31-350 (Chieftain), N411WL, crashed on the northeast slope of the Mauna Loa volcano near Volcano, Hawaii. The pilot and all nine passengers on board were killed, and the airplane was destroyed by impact forces and a postimpact fire. The sightseeing tour flight was operating under 14 Code of Federal Regulations (CFR) Part 135 as an on-demand air taxi operation. A visual flight rules (VFR) flight plan was filed, and visual meteorological conditions (VMC) existed at the Keahole-Kona International Airport (KOA), Kona, Hawaii, from which the airplane departed about 1622. The investigation determined that instrument meteorological conditions (IMC) prevailed in the vicinity of the accident site. The National Transportation Safety Board determines that the probable cause of this accident is the pilot's decision to continue visual flight into instrument meteorological conditions (IMC) in an area of cloud-covered mountainous terrain. Contributing to the accident were the pilot's failure to properly navigate and his disregard for standard operating procedures, including flying into IMC while on a visual flight rules flight plan and failure to obtain a current preflight weather briefing. KW - Air transportation crashes KW - Aviation safety KW - Clouds KW - Crash causes KW - Crash investigation KW - Fatalities KW - Hawaii Island (Hawaii) KW - Instrument flying KW - Visual flight KW - Volcanoes KW - Weather UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0102.pdf UR - https://trid.trb.org/view/904488 ER - TY - RPRT AN - 01104326 AU - National Transportation Safety Board TI - National Transportation Safety Board Railroad Accident Report: Collision of Amtrak Train 304-26 with a Highway Vehicle at a Highway-Rail Grade Crossing in McLean, Illinois, on September 26, 1999 PY - 2001/09/18 SP - 46p AB - On September 26, 1999, about 5:08 p.m. (central daylight time), northbound National Railroad Passenger Corporation (Amtrak) train 304-26, which was en route from St. Louis, Missouri, to Chicago, Illinois, collided with an automobile, which was westbound on U.S. Route 136. The collision occurred where the Union Pacific Railroad's St. Louis Division main line and U.S. Route 136 cross near McLean, Illinois. The automobile driver and passenger were killed as a result of the collision. Amtrak train 304-26 did not derail, and no injuries to the train crewmembers or passengers were reported. Neither the flashing lights nor the gates for the grade crossing activated to warn the automobile driver of the approaching train. The safety issues discussed in this report are Union Pacific Railroad.s signal maintenance procedures, Union Pacific Railroad.s postaccident site securement procedures for highway-rail grade crossing accidents, and postaccident toxicological testing. As a result of its investigation, the Safety Board issued safety recommendations to the Federal Railroad Administration, the Union Pacific Railroad, and the Brotherhood of Railroad Signalmen. KW - Amtrak KW - Crashes KW - Grade crossing protection systems KW - Ground transportation crashes KW - Public transit KW - Railroad crashes KW - Railroad transportation KW - Transit operating agencies KW - Warning systems UR - http://ntl.bts.gov/lib/18000/18400/18436/PB2001916303.pdf UR - https://trid.trb.org/view/863965 ER - TY - RPRT AN - 00821203 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-17 THROUGH H-01-25 PY - 2001/09/10 SP - 6 p. AB - These safety recommendations, addressed to Ms. Julie Anna Cirillo, Acting Deputy Administrator, Federal Motor Carrier Safety Administration, recommend that the Federal Motor Carrier Safety Administration develop a comprehensive medical oversight program for interstate commercial drivers that contains the following program elements: Individuals performing medical examinations for drivers are qualified to do so and are educated about occupational issues for drivers (H-01-17); A tracking mechanism is established that ensures that every prior application by an individual for medical certification is recorded and reviewed (H-01-18); Medical certification regulations are updated periodically to permit trained examiners to clearly determine whether drivers with common medical conditions should be issued a medical certificate (H-01-19); Individuals performing examinations have specific guidance and a readily identifiable source of information for questions on such examinations (H-01-20); The review process prevents, or identifies and corrects, the inappropriate issuance of medical certification (H-01-21); Enforcement authorities can identify invalid medical certification during safety inspections and routine stops (H-01-22); Enforcement authorities can prevent an uncertified driver from driving until an appropriate medical examination takes place (H-01-23); Mechanisms for reporting medical conditions to the medical certification and reviewing authority and for evaluating these conditions between medical certification exams are in place; individuals, health care providers, and employers are aware of these mechanisms (H-01-24). It is also recommended that the Federal Motor Carrier Safety Administration develop a system that records all positive drug and alcohol test results and refusal determinations that are conducted under the U.S. Department of Transportation testing requirements, require prospective employers to query the system before making a hiring decision, and require certifying authorities to query the system before making a certification decision (H-01-25). KW - Alcohol tests KW - Certification KW - Commercial drivers KW - Decision making KW - Diseases and medical conditions KW - Drivers KW - Drug tests KW - Hiring policies KW - Identification systems KW - Interstate transportation KW - Medical examinations and tests KW - Medical records KW - Motor carriers KW - Oversight KW - Recommendations KW - Regulations KW - Reports KW - Reviews KW - Transportation safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_17_25.pdf UR - https://trid.trb.org/view/712709 ER - TY - RPRT AN - 00821204 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-26 PY - 2001/09/10 SP - 5 p. AB - This safety recommendation, addressed to Ms. Linda Lewis, President and Chief Executive Officer, American Association of Motor Vehicle Administrators, recommends that the American Association of Motor Vehicle Administrators urge their member States to develop a comprehensive medical oversight program for interstate commercial drivers that contains the following program elements: Individuals performing medical examinations for drivers are qualified to do so and are educated about occupational issues for drivers; A tracking mechanism is established that ensures that every prior application by an individual for medical certification is recorded and reviewed; Medical certification regulations are updated periodically to permit trained examiners to clearly determine whether drivers with common medical conditions should be issued a medical certificate; Individuals performing examinations have specific guidance and a readily identifiable source of information for questions on such examinations; The review process prevents, or identifies and corrects, the inappropriate issuance of medical certification; Enforcement authorities can identify invalid medical certification during safety inspections and routine stops; Enforcement authorities can prevent an uncertified driver from driving until an appropriate medical examination takes; Mechanisms for reporting medical conditions to the medical certification and reviewing authority and for evaluating these conditions between medical certification exams are in place; individuals, health care providers, and employers are aware of these mechanisms. (H-01-26) KW - Certification KW - Commercial drivers KW - Diseases and medical conditions KW - Inspection KW - Interstate transportation KW - Medical certification KW - Medical examinations and tests KW - Medical records KW - Oversight KW - Qualifications KW - Recommendations KW - Reports KW - Reviews KW - Transportation safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_26.pdf UR - https://trid.trb.org/view/712710 ER - TY - RPRT AN - 00821205 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-27 PY - 2001/09/10 SP - 2 p. AB - This safety recommendation, addressed to Mr. William T. Pound, Executive Director, National Conference of State Legislatures recommends that the National Conference of State Legislatures inform State legislatures about a bus accident that occurred in New Orleans, Louisiana, on May 9, 1999. The bus, carrying 43 passengers departed the right side of the highway, veered off the road, sliding and bouncing along the way, and the resulting accident killed 22 passengers. The driver had known serious medical conditions and was able to obtain medical certification by falsifying and omitting crucial health history information from the examination form. In the 2 years before the accident, several physicians and health care providers treated the bus driver for heart failure and kidney failure. Many of the healthcare providers and physicians knew the bus driver's profession, but no one attempted to contact the State licensing authority regarding his fitness to operate a commercial vehicle. It is recommended that the State legislatures be made aware of the importance of establishing immunity laws for the good-faith reporting of potentially impaired commercial drivers by all individuals and of ensuring that the medical community and the commercial transportation industry are familiar with these laws (H-01-27). KW - Bus crashes KW - Bus drivers KW - Certification KW - Commercial drivers KW - Diseases and medical conditions KW - Fatalities KW - Highway safety KW - Immunity (Law) KW - Laws KW - Medical certification KW - Medical examinations and tests KW - Medical personnel KW - Medical treatment KW - Physicians KW - Recommendations KW - Reports KW - Traffic safety KW - Transportation safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_27.pdf UR - https://trid.trb.org/view/712711 ER - TY - RPRT AN - 00822791 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: MOTORCOACH RUN-OFF-THE-ROAD ACCIDENT, NEW ORLEANS, LOUISIANA, MAY 9, 1999 PY - 2001/08/28 SP - 128 p. AB - On May 9, 1999, about 9:00 a.m., a 1997 Motor Coach Industries 55-passenger motorcoach, operated by Custom Bus Charters, Incorporated, was traveling eastbound on Interstate 610 in New Orleans, Louisiana. The bus, carrying 43 passengers, was en route from La Place, Louisiana, to a casino approximately 80 miles away in Bay St. Louis, Mississippi. As the bus approached milepost 1.6, it departed the right side of the highway, crossed the shoulder, and went onto the grassy side slope alongside the shoulder. The bus continued on the side slope, struck the terminal end of a guardrail, traveled through a chain-link fence, vaulted over a paved golf cart path, collided with the far side of a dirt embankment, and then bounced and slid forward upright to its final resting position. Twenty-two passengers were killed, the bus driver and 15 passengers received serious injuries, and 5 passengers received minor injuries. The following major safety issues were identified in this accident: Inadequacy of the medical certification process, including the current Federal regulations; Absence of a mechanism for identifying drivers who have tested positive for drugs; Lack of Federal regulations or standards regarding passive and active occupant protection systems on large buses sold or operated in the United States; and Degraded condition of the guardrail posts along the interstate at the accident site. As a result of this accident investigation, the Safety Board makes recommendations to the Federal Motor Carrier Safety Administration, the American Association of Motor Vehicle Administrators, the National Conference of State Legislatures, the American Association of State Highway and Transportation Officials, and the State of Louisiana Department of Transportation and Development. In addition, the Safety Board is reiterating recommendations from its 1999 bus crashworthiness special investigation report to the National Highway Traffic Safety Administration. KW - Bus drivers KW - Buses KW - Certification KW - Crashworthiness KW - Drugged drivers KW - Fatalities KW - Guardrails KW - Injuries KW - Medical examinations and tests KW - New Orleans (Louisiana) KW - Occupant protection devices KW - Posts KW - Ran off road crashes KW - Recommendations UR - http://ntl.bts.gov/lib/18000/18400/18433/PB2001916201.pdf UR - https://trid.trb.org/view/713243 ER - TY - RPRT AN - 01003102 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Liberian Containership Columbus Canada and U.S. Fishing Vessel Black Sheep, Gulf of Mexico near Galveston, Texas, December 21, 1998 PY - 2001/08/22 SP - 4p AB - On December 21, 1998, the Liberian containership Columbus Canada and the U.S. commercial fishing vessel Black Sheep collided in the Inner Bar Channel of the Gulf of Mexico. At the time of the collision, channel visibility was reduced nearly to zero due to fog. The pilot of the Columbus Canada acquired a radar contact at a range of 4 1/2 miles, while The Black Sheep master acquired the Columbus Canada on radar about 11/2 mile ahead. Each vessel reported that they had made radio calls but received no response. Neither vessel's crew visually sighted the other vessel until moments before the collision. Also, neither vessel reduced speed before the collision. At impact, the Black Sheep's hull was breached and immediately began to flood. Immediately after impact, the pilot on the Columbus Canada stopped the main engine and steered to the left to remain in the channel. The Black Sheep continued to flood and sank. The National Transportation Safety Board has determined that the probable cause of the collision between the Columbus Canada and the Black Sheep was the decision by the master of the Black Sheep to turn directly into the path of the on-coming ship. KW - Channels (Waterways) KW - Containerships KW - Crash causes KW - Crash investigation KW - Fishing vessels KW - Fog KW - Gulf of Mexico KW - Ship navigational aids KW - Ship pilotage KW - Sinking (Oceanography) KW - Visibility KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0104.pdf UR - https://trid.trb.org/view/759278 ER - TY - RPRT AN - 01003113 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of U.S. Towboat Christine Cenac, U.S. Tank Barge CTCO 211, and U.S. Towboat American Heritage, Lower Mississippi River near Donaldsonville, Louisiana, January 28, 1998 PY - 2001/08/21 SP - 4p AB - At 0250 on June 27, 1998, the U.S. towboat American Heritage was downbound in the Lower Mississippi River near Philadelphia Point. Another tow, the U.S. towboat Christine Cenac was also downbound directly behind the American Heritage. The Christine Cenac was pushing two tank barges, the CTC0 210 and the CTC0 211, which were loaded with about 20,000 barrels of crude oil. The operator of the Christine Cenac was given permission to overtake and pass the American Heritage on its starboard side after the American Heritage completed the turn around Philadelphia Point but before the American Heritage reached the bend at 81-Mile Point. When the two tows were about 3/4 of a mile apart, the operator of the Christine Cenac observed the American Heritage move crosswise in the channel, with the head of the tow near the right descending bank and the stern of the tow near the left descending bank. Such a move is normal for a large tow flanking a sharp bend. During the subsequent attempt by the operator of the Christine Cenac to pass between the American Heritage and the left descending bank of the river, the port side of CTCO 211 struck the stern of the American Heritage. The force of the impact ruptured the No. 3 port cargo tank of CTCO 211, causing approximately 1680 barrels of crude oil to spill into the Mississippi River. After the collision, the Coast Guard closed over 14 miles of the river to vessel traffic so that containment and clean-up operations could be undertaken. The National Transportation Safety Board determines the probable cause of the collision between the Christine Cenac with tow and the American Heritage was the decision by the operator of the Christine Cenac to attempt to overtake and pass the American Heritage tow while the American Heritage operator was making a flanking maneuver at a sharp bend in the river. KW - Crash causes KW - Crash investigation KW - Louisiana KW - Mississippi River KW - Oil spills KW - Rivers KW - Ship pilotage KW - Tank barges KW - Towboats KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0103.pdf UR - https://trid.trb.org/view/759277 ER - TY - RPRT AN - 00816409 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION INVOLVING THREE CONSOLIDATED RAIL CORPORATION FREIGHT TRAINS OPERATING IN FOG ON A DOUBLE MAIN TRACK NEAR BRYAN, OHIO, JANUARY 17, 1999 PY - 2001/08/09 SP - 61 p. AB - About 1:58 a.m. eastern standard time on January 17, 1999, three Consolidated Rail Corporation (Conrail) freight trains operating in fog on a double main track were involved in an accident near Bryan, Ohio. Westbound Mail-9, traveling near maximum authorized speed on track No. 1, struck the rear or a slower moving westbound train, TV-7, at milepost 337.22. The collision caused the derailment of the 3 locomotive units and the first 13 cars of Mail-9 and the last 3 cars of TV-7. The derailed equipment fouled the No. 2 track area and struck the 12th car of train MGL-16, which was operating eastbound on the adjacent track. The impact caused 18 cars in the MGL-16 consist to derail. The engineer and conductor of Mail-9 were killed in the accident. The crewmembers of TV-7 and MGL-16 were not injured. Total estimated damages were $5.3 million. The safety issues discussed in this report are as follows: train movement under reduced visibility conditions, positive train control for collision avoidance, and adequacy of recorded information for post accident analysis. As a result of its investigation of this accident, the Safety Board makes safety recommendations to the Federal Railroad Administration, all Class I railroads, the Brotherhood of Locomotive Engineers, the United Transportation Union, the Association of American Railroads, and the American Short Line and Regional Railroad Association. Additionally, the Safety Board reiterates one and reclassifies three safety recommendations to the Federal Railroad Administration. KW - Bryan (Ohio) KW - Conrail KW - Crash avoidance systems KW - Crash reports KW - Derailments KW - Fatalities KW - Fog KW - Freight trains KW - Loss and damage KW - Positive train control KW - Railroad crashes KW - Recommendations KW - Safety UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0101.pdf UR - https://trid.trb.org/view/690723 ER - TY - RPRT AN - 01003091 AU - National Transportation Safety Board TI - Marine Accident Brief: Sinking of the U.S. Fishing Vessel Miss Penelope, South of Montauk, New York, January 28, 1998 PY - 2001/08/03 SP - 3p AB - On January 28, 1998, the U.S. fishing vessel Miss Penelope was riding out heavy weather in the Atlantic Ocean, south of Montauk, New York, by drifting with the wind and seas. Prior to the accident, the vessel was prepared for heavy weather and no problems were reported. About 1300, the vessel took heavy seas on the starboard side and heeled over very hard to port. The after deck did not immediately recover from the roll to port, and the Miss Penelope began to sink by the stern. The master warned the mate and the deckhands that the vessel was sinking and then started the vessel's main engine. The master maneuvered the vessel into the wind in an attempt to clear water from the after deck. The crew donned their survival suits, launched the vessel's inflatable life raft, and activated three emergency position indicating radio beacons. The master radioed a report of the vessel's position to the nearest U.S. Coast Guard station and notified them that the vessel would sink within 10 minutes. The crew abandoned ship shortly before the Miss Penelope capsized. The master, mate, and one of the deckhands boarded the life raft. The second deckhand, however, did not make it to the life raft and soon drifted out of sight of the other crewmembers. Heavy seas buffeted the life raft and the sea toppled it over 8 or 9 times. Each time that the sea turned the raft over, the crewmembers righted it and boarded it again. Coast Guard rescue helicopters pulled the crew from the life boat and water. Three crew members were injured; one fatality resulted. Property damage was estimated at $500,000. The National Transportation Safety Board determines that the probable cause of the sinking of the commercial fishing vessel Miss Penelope was flooding resulting from an unknown origin while the vessel drifted in heavy seas KW - Atlantic Ocean KW - Crash causes KW - Crash investigation KW - Disasters and emergency operations KW - Drowning KW - Fatalities KW - Fishing vessels KW - Floods KW - Injuries KW - New York (State) KW - Sinking (Oceanography) KW - Storms KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0103.pdf UR - https://trid.trb.org/view/759286 ER - TY - RPRT AN - 01003115 AU - National Transportation Safety Board TI - Marine Accident Brief Report: Fire on Board the Netherlands-Registered Passenger Ship Nieuw Amsterdam at Glacier Bay, Alaska, May 23, 2000 PY - 2001/07/24 SP - 29p AB - On the morning of May 23, 2000, while the Netherlands-registered passenger ship Nieuw Amsterdam was en route to Glacier National Park with 1,169 passengers and 542 crewmembers on board, a fire broke out in a crew cabin. A premature effort to extinguish the fire by officers lacking proper gear and backup contributed to the spread of fire and smoke. The fire did not spread beyond the deck of origin; however, the untimely closing of fire screen doors allowed the smoke to migrate up eight decks, creating hazardous conditions in crew and passenger accommodations. Properly outfitted and equipped shipboard firefighting teams subsequently extinguished the fire. One passenger sustained smoke inhalation injuries requiring evacuation to a shoreside hospital for additional medical treatment. Property damage to the vessel was estimated at more than $360,000. The National Transportation Safety Board determines that the probable cause of the fire on board the Nieuw Amsterdam was the unauthorized use of an electrical appliance that had been left unattended and plugged into an electrical outlet in a crew cabin. Contributing to the extent of the fire damage and spread of smoke was a breakdown in firefighting command and control by the vessel's master and senior officers. Recommendations are made to the U.S. Coast Guard, Holland America Lines, and other passenger cruise lines. KW - Alaska KW - Crash causes KW - Crash investigation KW - Cruise ships KW - Fire causes KW - Fire fighting KW - Fires KW - Holland America Line KW - Maritime safety KW - Netherlands KW - Passenger ships KW - Recommendations KW - Smoke KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MBR0101.pdf UR - https://trid.trb.org/view/759271 ER - TY - RPRT AN - 01014912 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Hazardous Liquid Pipe Failure and Leak, Explorer Pipeline Company, Greenville, Texas, March 9, 2000 PY - 2001/07/06 SP - 4p AB - On March 9, 2000, about 10:20 p.m., central standard time, a 28-inch-diameter pipeline owned and operated by Explorer Pipeline Company (Explorer) ruptured and released 13,436 barrels (about 564,000 gallons) of gasoline. The pipeline was buried about 4 feet 6 inches under ranch land. The release site was near Greenville, Texas, about 45 miles northeast of Dallas. The National Transportation Safety Board determines that the probable cause of the pipeline failure was corrosion-fatigue cracking that initiated at the edge of the longitudinal seam weld at a likely pre-existing weld defect. Contributing to the failure was the loss of pipe coating integrity. KW - Corrosion KW - Cracking KW - Crash causes KW - Defects KW - Explorer Pipeline Company KW - Fatigue (Mechanics) KW - Gas pipelines KW - Gasoline KW - Greenville (Texas) KW - Hazardous materials KW - Leakage KW - Pipe coating integrity KW - Pipeline accidents KW - Pipeline failures KW - Pipeline safety KW - Rupture KW - Welds UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB0103.pdf UR - https://trid.trb.org/view/771547 ER - TY - RPRT AN - 00967084 AU - Engleman, E G AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-03-08 AND H-03-09 PY - 2001/06/13 SP - 8 p. AB - These safety recommendations, addressed to the governors of 33 states, recommend that the 33 states that do not have legislation prohibiting holders of learner's permits and intermediate licenses from using interactive wireless communication devices and that do not have driver distraction codes on their traffic accident investigation forms (1) enact legislation to prohibit holders of learner's permits and intermediate licenses from using interactive wireless communication devices while driving (H-03-08); (2) add driver distraction codes, including codes for interactive wireless communication device use, to their traffic investigation forms (H-03-09). KW - Cellular telephones KW - Crash investigation KW - Distraction KW - Drivers KW - Forms of business or industry KW - Graduated licensing KW - Hazards KW - Highway safety KW - Intermediate licenses KW - Legislation KW - Novices KW - Recommendations KW - States KW - Traffic crashes KW - Traffic safety KW - Wireless communication systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H03_08_09.pdf UR - https://trid.trb.org/view/678455 ER - TY - RPRT AN - 01014922 AU - National Transportation Safety Board TI - Pipeline Accident Report: Natural Gas Explosion and Fire in South Riding, Virginia, July 7, 1998 PY - 2001/06/12 SP - 35p AB - About 12:25 a.m. on July 7, 1998, a natural gas explosion and fire destroyed a newly constructed residence in the South Riding community in Loudoun County, Virginia. A family consisting of a husband and wife and their two children were spending their first night in their new home at the time of the explosion. As a result of the accident, the wife was killed, the husband was seriously injured, and the two children received minor injuries. Five other homes and two vehicles were damaged. The safety issues identified during this investigation were (1) the adequacy of standards for minimum separation distances between gas service lines and electrical service lines and (2) the lack of a requirement for the installation of excess flow valves. As a result of this investigation, the Safety Board made two recommendations to the Research and Special Programs Administration (RSPA) and one recommendation each to the Edison Electric Institute, the National Rural Electric Cooperative Association, the American Power Association, and the U.S. Department of Agriculture’s Rural Utilities Service. KW - Adults KW - Children KW - Distance KW - Dwellings KW - Electrical service lines KW - Excess flow valves KW - Explosions KW - Fatalities KW - Fire KW - Gas service lines KW - Injuries KW - Loudoun County (Virginia) KW - Natural gas KW - Pipeline accidents KW - Pipeline safety KW - Recommendations KW - Requirements KW - Residential areas KW - Standards UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0101.pdf UR - https://trid.trb.org/view/771546 ER - TY - RPRT AN - 00821164 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-12 THROUGH H-01-14 PY - 2001/05/25 SP - 4 p. AB - These safety recommendations are addressed to Mr. Jacques A. Nasser, President and Chief Executive Officer, Ford Motor Company; Mr. G. Richard Wagoner, President and Chief Executive Officer, General Motors Corporation; and Mr. Norihiko Oda, Chairman and Chief Executive Officer, Isuzu Motors America, Incorporated. They recommend that the truck and automobile manufacturers: (1) develop and implement, in cooperation with the National Highway Traffic Safety Administration, the Federal Highway Administration, the Intelligent Transportation Society of America, and automobile manufacturers, a program to inform the public and commercial drivers on the benefits, use, and effectiveness of collision warning systems and adaptive cruise controls (H-01-12); (2) develop a training program for operators of vehicles equipped with a collision warning system or an adaptive cruise control and provide this training to the vehicle operators (H-01-13); (3) develop and implement, in cooperation with the National Highway Traffic Safety Administration, the Federal Highway Administration, the Intelligent Transportation Society of America, and the truck and motorcoach manufacturers, a program to inform the public and commercial drivers on the benefits, use, and effectiveness of collision warning systems and adaptive cruise controls (H-01-14). KW - Adaptive control KW - Automobiles KW - Benefits KW - Buses KW - Commercial vehicles KW - Crash avoidance systems KW - Cruise control KW - Drivers KW - Industries KW - ITS America KW - Operators (Persons) KW - Proximity detectors KW - Public information programs KW - Recommendations KW - Traffic safety KW - Training programs KW - Trucks KW - U.S. Federal Highway Administration KW - U.S. National Highway Traffic Safety Administration KW - U.S. National Transportation Safety Board KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_12_14.pdf UR - https://trid.trb.org/view/712658 ER - TY - RPRT AN - 00821163 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-10 AND H-01-11 PY - 2001/05/25 SP - 4 p. AB - This safety recommendation, addressed to Mr. Vincent Schinmoller, Deputy Executive Director, Federal Highway Administration, recommends that the Federal Highway Administration (1) develop and implement, in cooperation with the National Highway Traffic Safety Administration; the Intelligent Transportation Society of America; and the truck, motorcoach and automobile manufacturers, a program to inform the public and commercial drivers on the benefits, use, and effectiveness of collision warning systems and adaptive cruise controls (H-01-10). (2) develop a procedure that States can use to conduct a risk analysis for work zone backups; require, where appropriate, the use of a queue length detection and warning system; and incorporate that procedure for a queue length detection and warning system for work zones in the manual on Uniform Traffic Control Devices work zone guidelines (H-01-11). KW - Adaptive control KW - Automobiles KW - Benefits KW - Buses KW - Commercial vehicles KW - Crash avoidance systems KW - Cruise control KW - Detectors KW - Drivers KW - Industries KW - Length KW - Manual on Uniform Traffic Control Devices KW - Proximity detectors KW - Public information programs KW - Queuing KW - Recommendations KW - Risk analysis KW - Traffic safety KW - Trucks KW - Warning systems KW - Work zone traffic control KW - Work zones UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_10_11.pdf UR - https://trid.trb.org/view/712657 ER - TY - RPRT AN - 00821165 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-15 PY - 2001/05/25 SP - 3 p. AB - This safety recommendation, addressed to Mr. David Hensing, President, Intelligent Transportation Society of America, recommends that the Intelligent Transportation Society of America develop and implement, in cooperation with the National Highway Traffic Safety Administration, the Federal Highway Administration, and the truck and motorcoach manufacturers, a program to inform the public and commercial drivers on the benefits, use, and effectiveness of collision warning systems and adaptive cruise controls. KW - Adaptive control KW - Automobiles KW - Benefits KW - Buses KW - Commercial vehicles KW - Crash avoidance systems KW - Cruise control KW - Drivers KW - Industries KW - ITS America KW - Proximity detectors KW - Public information programs KW - Recommendations KW - Traffic safety KW - Trucks KW - U.S. Federal Highway Administration KW - U.S. National Highway Traffic Safety Administration KW - U.S. National Transportation Safety Board KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_15.pdf UR - https://trid.trb.org/view/712659 ER - TY - RPRT AN - 00821166 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-16 PY - 2001/05/25 SP - 3 p. AB - This safety recommendation is addressed to Mr. Walter B. McCormick, Jr., President and Chief Executive Officer, American Trucking Associations, Inc.; Mr. John McQuaid, President and Chief Executive Officer, National Private Truck Council; and Mr. Jim Johnston, President, Owner-operator Independent Driver Association. It recommends that the American Trucking Associations, Inc.; National Private Truck Council; and the Owner-Operator Independent Driver Association: Encourage your members to obtain or provide, or both, training to those drivers who operate collision warning system- or adaptive cruise control-equipped trucks. KW - Adaptive control KW - Crash avoidance systems KW - Cruise control KW - Owner operators KW - Proximity detectors KW - Recommendations KW - Traffic safety KW - Training KW - Truck drivers KW - Trucks KW - U.S. National Transportation Safety Board KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_16.pdf UR - https://trid.trb.org/view/712660 ER - TY - RPRT AN - 00821162 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-09 PY - 2001/05/25 SP - 3 p. AB - This safety recommendation, addressed to Mr. Robert Shelton, Acting Administrator, National Highway Traffic Safety Administration, recommends that the National Highway Traffic Safety Administration develop and implement, in cooperation with the Federal Highway Administration; the Intelligent Transportation Society of America; and the truck, motorcoach and automobile manufacturers, a program to inform the public and commercial drivers on the benefits, use, and effectiveness of collision warning systems and adaptive cruise controls. KW - Adaptive control KW - Automobiles KW - Benefits KW - Commercial drivers KW - Crash avoidance systems KW - Cruise control KW - Industries KW - Public information programs KW - Recommendations KW - Traffic safety KW - Trucks KW - U.S. Department of Transportation KW - U.S. Federal Highway Administration KW - U.S. National Highway Traffic Safety Administration KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_09.pdf UR - https://trid.trb.org/view/712656 ER - TY - RPRT AN - 00821161 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-06 THROUGH H-01-08 PY - 2001/05/25 SP - 5 p. AB - These safety recommendations, addressed to the Honorable Norman Y. Mineta, Secretary, U.S. Department of Transportation, recommends that the U.S. Department of Transportation: (1) Complete rulemaking on adaptive cruise control and collision warning system performance standards for new commercial vehicles. At a minimum, these standards should address obstacle detection distance, timing of alerts, and human factors guidelines, such as the mode and type of warning (H-01-06). (2) After promulgating performance standards for collision warning systems for commercial vehicles, require that all new commercial vehicles be equipped with a collision warning system (H-01-07). (3) Complete rulemaking on adaptive cruise control and collision warning system performance standards for new passenger cars. At a minimum, these standards should address obstacle detection distance, timing of alerts, and human factors guidelines, such as the mode and type of warning (H-01-08). KW - Adaptive control KW - Commercial vehicles KW - Crash avoidance systems KW - Cruise control KW - Distance KW - Human factors KW - Passenger vehicles KW - Performance KW - Proximity detectors KW - Recommendations KW - Standards KW - Time KW - Traffic safety KW - U.S. Department of Transportation KW - U.S. National Transportation Safety Board KW - Warning signals KW - Warning systems UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_06_08.pdf UR - https://trid.trb.org/view/712655 ER - TY - RPRT AN - 01003111 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision of Two Recreational Motorboats on the St. Croix River near Bayport, Minnesota, July 3, 1999 PY - 2001/05/09 AB - About 0125 on July 3, 1999, a 27-foot Advantage recreational motorboat with three men on board and a 22-foot Bayliner recreational motorboat with two men on board collided on the St. Croix River near Bayport, Minnesota. No one witnessed the accident; however, the damage path across the top of the Bayliner indicated that the Advantage struck the starboard side of the Bayliner, forward of the windshield, and passed over the motorboat. All five occupants of the two motorboats died as a result of the collision. The three occupants of the Advantage died from drowning. The two occupants of the Bayliner died from blunt force trauma. The National Transportation Safety Board determines that the probable cause of the collision between the Advantage and Bayliner recreational vessels was alcohol impairment, which led the two boat operators to indulge in high speed operations at night, and which impaired their ability to determine the movements of other vessels and to take appropriate action to avoid a collision. KW - Alcohol use KW - Blunt force trauma KW - Boating safety KW - Boats KW - Crash causes KW - Crash investigation KW - Crashes KW - Drowning KW - Fatalities KW - Motor boats KW - Speeding KW - St. Croix River KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB0101.pdf UR - https://trid.trb.org/view/759302 ER - TY - RPRT AN - 01014945 AU - National Transportation Safety Board TI - Pipeline Accident Brief: Hazardous Liquid Pipe Failure and Leak, Marathon Ashland Pipe Line, LLC Winchester, Kentucky, January 27, 2000 PY - 2001/05/03 SP - 5p AB - About 12:12 p.m. CST on January 27, 2000, a Marathon Ashland Pipe Line LLC (Marathon Ashland) 24-inch-diameter pipeline that runs 265 miles between Owensboro and Catlettsburg, Kentucky, ruptured near Winchester, Kentucky. The ruptured pipeline released about 11,644 barrels (about 489,000 gallons) of crude oil onto a golf course and into Twomile Creek. No injuries or deaths resulted from the accident. As of December 13, 2000, Marathon Ashland had spent about $7.1 million in response to the accident. The probable cause of the accident was fatigue cracking due to a dent in the pipe that, in combination with fluctuating pressures within the pipe, produced high local stresses in the pipe wall. Contributing to the severity of the accident was the failure of the controller and supervisors to timely recognize the rupture, shut down the pipeline, and isolate the ruptured section of the pipeline. KW - Costs KW - Cracking KW - Crash causes KW - Crude oil KW - Disasters and emergency operations KW - Fatigue (Mechanics) KW - Hazardous materials KW - Leakage KW - Liquids KW - Pipeline accidents KW - Pipeline failures KW - Pipeline safety KW - Pressure KW - Stresses KW - Winchester (Kentucky) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAB0102.pdf UR - https://trid.trb.org/view/771548 ER - TY - RPRT AN - 01003121 AU - National Transportation Safety Board TI - Marine Accident Report: Fire On Board The Liberian Passenger Ship Ecstasy, Miami, Florida, July 20, 1998 PY - 2001/05/01 SP - 103p AB - On July 20, 1998, the Liberian passenger ship Ecstasy was en route to Key West, Florida, with 2,565 passengers and 916 crewmembers on board when a fire started in the main laundry shortly after 1700. The fire migrated through the ventilation system to the aft mooring deck where mooring lines ignited, creating intense heat and large amounts of smoke. As the Ecstasy was attempting to reach an anchorage north of the Miami sea buoy, the vessel lost propulsion power and steering and began to drift. The master radioed the U.S. Coast Guard for assistance. Six tugboats responded to help fight the fire and to tow the Ecstasy. The fire was brought under control by onboard firefighters and was officially declared extinguished about 2109. Fourteen crewmembers and eight passengers suffered minor injuries. One passenger who required medical treatment as a result of a pre-existing condition was categorized as a serious injury victim because of the length of her hospital stay. Losses from the fire and associated damages exceeded $17 million. The National Transportation Safety Board determines that the probable cause of fire aboard the Ecstasy was the unauthorized welding by crewmembers in the main laundry that ignited a large accumulation of lint in the ventilation system and the failure of Carnival Cruise Lines to maintain the laundry exhaust ducts in a fire-safe condition. Contributing to the extensive fire damage on the ship was the lack of an automatic fire suppression system on the aft mooring deck and the lack of an automatic means of mitigating the spread of smoke and fire through the ventilation ducts. The major safety issues discussed in this report are as follows: adequacy of management safety oversight; adequacy of the fire protection systems; adequacy of passenger and crew safety; and adequacy of engineering system design. As result of its investigation of this accident, the Safety Board makes recommendations to the U.S. Coast Guard, Carnival Corporation, Inc., Carnival Cruise Lines, 11 other cruise lines, and the International Association of Classification Societies. KW - Carnival Cruise Lines KW - Crash causes KW - Crash investigation KW - Cruise lines KW - Cruise ships KW - Fire causes KW - Fire fighting equipment KW - Fires KW - Florida KW - Injuries KW - International Association of Classification Societies KW - Liberia KW - Loss and damage KW - Maritime safety KW - Oversight KW - Recommendations KW - United States Coast Guard KW - Ventilation systems KW - Water transportation crashes UR - http://ntl.bts.gov/lib/18000/18400/18438/PB2001916401.pdf UR - https://trid.trb.org/view/759301 ER - TY - RPRT AN - 00816382 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT: VEHICLE- AND INFRASTRUCTURE-BASED TECHNOLOGY FOR THE PREVENTION OF REAR-END COLLISIONS PY - 2001/05/01 SP - 59 p. AB - Between 1999 and 2000, the National Transportation Safety Board investigated nine rear-end collisions in which 20 people died and 181 were injured. Common to all nine accidents was the rear following vehicle driver's degraded perception of traffic conditions ahead. As the Safety Board reported in 1995 and further discussed at its 1999 public hearing, existing technology in the form of Intelligent Transportation Systems can prevent rear-end collisions. In the nine accidents investigated by the Safety Board, one (and sometimes more) of the available technologies would have helped alert the drivers to the vehicles ahead, so that they could slow their vehicles, and would have prevented or mitigated the circumstances of the collisions. The major issue addressed in this Safety Board special investigation report is the prevention of rear-end collisions through the use of Intelligent Transportation Systems. This report also discusses some of the challenges, including implementation, consumer acceptance, public perception, and training, associated with the deployment of vehicle- and infrastructure-based collision warning systems. As a result of its investigation, the Safety Board issued recommendations to the U.S. Department of Transportation; the Federal Highway Administration; the National Highway Traffic Safety Administration; truck, motorcoach, and automobile manufacturers; the Intelligent Transportation Society of America; the American Trucking Associations, Inc.; the Owner-Operator Independent Driver Association; and the National Private Truck Council. KW - Crash avoidance systems KW - Crash investigation KW - Deployment KW - Implementation KW - Intelligent transportation systems KW - Prevention KW - Rear end crashes KW - Recommendations UR - http://www.ntsb.gov/news/events/Documents/truck_bus-SIR0101.pdf UR - https://trid.trb.org/view/690693 ER - TY - RPRT AN - 00814158 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED DESCENT AND COLLISION WITH TERRAIN, UNITED AIRLINES FLIGHT 585, BOEING 737-200, N999UA, 4 MILES SOUTH OF COLORADO SPRINGS MUNICIPAL AIRPORT, COLORADO SPRINGS, COLORADO, MARCH 3, 1991 PY - 2001/03/27 SP - 212 p. AB - This amended report explains the accident involving United Airlines flight 585, a Boeing 737-200, which entered an uncontrolled descent and impacted terrain 4 miles south of Colorado Springs Municipal Airport, Colorado Springs, Colorado, on March 3, 1991. Safety issues discussed in the report are the potential meteorological hazards to airplanes in the area of Colorado Springs; 737 rudder malfunctions, including rudder reversals; and the design of the main rudder power control unit servo valve. KW - Air transportation crashes KW - Crash investigation KW - Hazards KW - Mechanical failure KW - Meteorological phenomena KW - Rudders KW - Servomechanisms KW - Valves UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0101.pdf UR - https://trid.trb.org/view/681548 ER - TY - RPRT AN - 00810961 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-02 PY - 2001/03/27 SP - 5 p. AB - This safety recommendation, addressed to Ms. Julie Anna Cirillo, Acting Deputy Administrator, Federal Motor Carrier Safety Administration, recommends that action be taken to address a safety issue concerning the use of automatic brake adjusters in air-braked commercial vehicles, particularly the use of Haldex Brake Products Corporation automatic brake adjusters with failed control arms. The National Transportation Safety Board identified the issue during its investigation of a fatal accident involving a motorcoach. KW - Air brakes KW - Automatic brake adjusters KW - Brake components KW - Buses KW - Commercial vehicles KW - Crash investigation KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_02.pdf UR - https://trid.trb.org/view/679593 ER - TY - RPRT AN - 00810964 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-05 PY - 2001/03/27 SP - 6 p. AB - This safety recommendation, addressed to Mr. Stephen F. Campbell, Executive Director, Commercial Vehicle Safety Alliance, recommends that action be taken to address a safety issue concerning the use of automatic brake adjusters in air-braked commercial vehicles, particularly the use of Haldex Brake Products Corporation automatic brake adjusters with failed control arms. The National Transportation Safety Board identified the issue during its investigation of a fatal accident involving a motorcoach. KW - Air brakes KW - Automatic brake adjusters KW - Brake components KW - Buses KW - Commercial vehicles KW - Crash investigation KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_05.pdf UR - https://trid.trb.org/view/679597 ER - TY - RPRT AN - 00810963 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-04 PY - 2001/03/27 SP - 6 p. AB - This safety recommendation, addressed to Mr. Walter B. McCormick, President and Chief Executive Officer, American Trucking Associations, Inc., Mr. Peter Pantuso, President and Chief Executive Officer, American Bus Association, and Mr. Stephen G. Sprague, Chief Operating Officer, United Motorcoach Association, recommends that action be taken to address a safety issue concerning the use of automatic brake adjusters in air-braked commercial vehicles, particularly the use of Haldex Brake Products Corporation automatic brake adjusters with failed control arms. The National Transportation Safety Board identified the issue during its investigation of a fatal accident involving a motorcoach. KW - Air brakes KW - Automatic brake adjusters KW - Brake components KW - Buses KW - Commercial vehicles KW - Crash investigation KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_04.pdf UR - https://trid.trb.org/view/679596 ER - TY - RPRT AN - 00810962 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-03 PY - 2001/03/27 SP - 6 p. AB - This safety recommendation, addressed to Mr. Chuck Kleinhagen, President, Haldex Brake Products Corporation, recommends that action be taken to address a safety issue concerning the use of automatic brake adjusters in air-braked commercial vehicles, particularly the use of Haldex Brake Products Corporation automatic brake adjusters with failed control arms. The National Transportation Safety Board identified the issue during its investigation of a fatal accident involving a motorcoach. KW - Air brakes KW - Automatic brake adjusters KW - Brake components KW - Buses KW - Commercial vehicles KW - Crash investigation KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_03.pdf UR - https://trid.trb.org/view/679594 ER - TY - RPRT AN - 00810960 AU - Carmody, C J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-01-01 PY - 2001/03/27 SP - 5 p. AB - This safety recommendation, addressed to Mr. Robert Shelton, Executive Director, National Highway Traffic Safety Administration, recommends that action be taken to address a safety issue concerning the use of automatic brake adjusters in air-braked commercial vehicles, particularly the use of Haldex Brake Products Corporation automatic brake adjusters with failed control arms. The issue was identified during a National Transportation Safety Board investigation of a fatal accident involving a motorcoach. KW - Air brakes KW - Automatic brake adjusters KW - Brake components KW - Buses KW - Commercial vehicles KW - Crash investigation KW - Recommendations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H01_01.pdf UR - https://trid.trb.org/view/679591 ER - TY - RPRT AN - 00816408 AU - National Transportation Safety Board TI - HAZARDOUS MATERIALS ACCIDENT REPORT: RUPTURE OF A RAILROAD TANK CAR CONTAINING HAZARDOUS WASTE NEAR CLYMERS, INDIANA, FEBRUARY 18, 1999 PY - 2001/03/05 SP - 79 p. AB - About 12:05 a.m. on February 18, 1999, railroad tank car UTLX 643593, which was on the west unloading rack at the Essroc Cement Corporation plant near Clymers, Indiana, sustained a sudden and catastrophic rupture that propelled the tank of the tank car an estimated 750 ft and over multistory storage tanks. The 20,000-gallon tank car initially contained about 161,700 lb (14,185 gallons) of a toxic and flammable hazardous waste that was used as a fuel for the plant's kilns. There were no injuries or fatalities. Total damages, including property damage and costs from lost production, were estimated at nearly $8.2 million. The safety issues discussed in the report are: sufficiency of safety requirements addressing the procedures used for loading and offloading railroad tank cars and other bulk containers used to transport hazardous materials; adequacy of inspection and testing requirements for pressure relief devices on railroad tank cars; adequacy of provisions addressing changes in product service for railroad tank cars; and adequacy of the U.S. Department of Transportation "Hazardous Materials Regulations" pertaining to the notification and reporting of hazardous materials incidents. As a result of its investigation, the Safety Board made recommendations to the Federal Railroad Administration, the Research and Special Programs Administration, the Association of American Railroads, the Railway Progress Institute, the Lyondell Chemical Company, the Olin Corporation, the Essroc Cement Corporation, and CP Recycling, Inc., and Affiliated Companies. The Safety Board also reiterated one recommendation to the Research and Special Programs Administration. KW - Catastrophic ruptures KW - Clymers (Indiana) KW - Crash reports KW - Hazardous wastes KW - Inspection KW - Loss and damage KW - Pressure relief valves KW - Property damage KW - Recommendations KW - Safety KW - Tank cars KW - Testing KW - Unloading UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM0101.pdf UR - https://trid.trb.org/view/690722 ER - TY - RPRT AN - 00816495 AU - National Transportation Safety Board TI - SAFETY REPORT: SURVIVABILITY OF ACCIDENTS INVOLVING PART 121 U.S. AIR CARRIER OPERATIONS, 1983 THROUGH 2000 PY - 2001/03 SP - 27 p. AB - Despite the growing demands on the U.S. aviation system, the system continues to maintain a high level of safety. There are two ways to prevent fatalities in air travel: by preventing accidents, and by protecting aircraft occupants in the accidents that do occur. A reduction in accident rates provides an indication of the success of accident prevention; examining occupant survivability can indicate the positive results from occupant protection. The importance of examining occupant survivability in aviation accidents is twofold: (1) it can help to dispel a public perception that most air carrier accidents are not survivable, and (2) it can identify things that can be done to increase survivability in the accidents that do occur. The National Transportation Safety Board frequently receives inquiries from the general public and Government agencies concerning the survivability of airplane accidents. Although the Safety Board's "Annual Review of Aircraft Accident Data for U.S. Air Carrier Operations" summarizes the degree of occupant injury by aircraft damage, the annual publication has not, in the past, analyzed the issue of survivability in detail. Therefore, the purpose of this safety report is to examine aircraft occupant survivability for air carrier operations in the United States. The Safety Board examined only air carrier operations performed under Title 14 Code of Federal Regulations Part 121 because the majority of the Board's survival factors investigations are conducted in connection with accidents involving Part 121 carriers. Therefore, more survivability data are available for Part 121 operations than are available for Part 135 and Part 91 (general aviation) operations. This report also examines cause-of-death information for the most serious of the Part 121 accidents; that is, those accidents involving fire, at least one serious injury or fatality, and either substantial aircraft damage or complete destruction. KW - Air transportation crashes KW - Aircraft damage KW - Cause-of-death information KW - Crash data KW - Crash investigation KW - Fatalities KW - Fire KW - Injuries KW - Survival KW - United States Code. Title 14. Part 121 KW - Vehicle occupants UR - http://app.ntsb.gov/doclib/safetystudies/SR0101.pdf UR - https://trid.trb.org/view/690772 ER - TY - RPRT AN - 01099633 AU - National Transportation Safety Board TI - Aircraft Accident Brief: Ground Impact of American Airlines 1340, Chicago, Illinois, February 9, 1998 PY - 2001 SP - 26p AB - On February 9, 1998, about 0954 central standard time (CST), a Boeing 727-223 (727), N845AA, operated by American Airlines as flight 1340, impacted the ground short of the runway 14R threshold at Chicago O’Hare International Airport (ORD) while conducting a Category II (CAT II) instrument landing system (ILS) coupled approach. Twenty-two passengers and one flight attendant received minor injuries, and the airplane was substantially damaged. The airplane, being operated by American Airlines as a scheduled domestic passenger flight under the provisions of 14 Code of Federal Regulations (CFR) Part 121, with 116 passengers, 3 flight crewmembers, and 3 flight attendants on board, was destined for Chicago, Illinois, from Kansas City International Airport (MCI), Kansas City, Missouri. Daylight instrument meteorological conditions prevailed at the time of the accident. The National Transportation Safety Board determines that the probable cause of this accident was the failure of the flight crew to maintain a proper pitch attitude for a successful landing or go-around. Contributing to the accident were the divergent pitch oscillations of the airplane, which occurred during the final approach and were the result of an improper autopilot desensitization rate. KW - Air transportation crashes KW - Altitude KW - American Airlines, Inc. KW - Automatic pilot KW - Aviation safety KW - Boeing 727 aircraft KW - Chicago O'Hare International Airport KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Domestic transportation KW - Landing KW - Oscillation KW - Pitch (Dynamics) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAB0101.pdf UR - https://trid.trb.org/view/855855 ER - TY - RPRT AN - 00929772 AU - National Transportation Safety Board TI - FIRE ON BOARD THE U.S. PASSENGER FERRY COLUMBIA CHATHAM STRAIT NEAR JUNEAU, ALASKA JUNE 6, 2000 PY - 2001 SP - 46 p. AB - This report discusses the June 6, 2000 fire that occurred on the Alaska Marine Highway System ferry Columbia while it was underway in Chatham Strait, near Juneau, Alaska. None of the 498 people on board were killed or sustained serious injury; however, three passengers were transported to a shoreside hospital for medical conditions that preexisted the fire. Damages related to the accident exceeded $2 million. From its investigation, the National Transportation Safety Board identified safety issues in the following areas: the adequacy of inspection and maintenance procedures for electrical systems; the adequacy of management safety oversight of maintenance procedures; and the adequacy of firefighting procedures. Based on its findings, the Safety Board made recommendations to the Alaska Marine Highway System. KW - Alaska KW - Crash investigation KW - Ferry service KW - Fire fighting equipment KW - Fires KW - Inspection KW - Maintenance management KW - Marine salvage KW - Safety factors KW - Safety management KW - Water transportation UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR0102.pdf UR - https://trid.trb.org/view/719322 ER - TY - RPRT AN - 00911835 AU - National Transportation Safety Board TI - PIPELINE ACCIDENT REPORT: NATURAL GAS EXPLOSION AND FIRE IN SOUTH RIDING, VIRGINIA, JULY 7, 1998 T2 - NATURAL GAS EXPLOSION AND FIRE IN SOUTH RIDING, VIRGINIA, JULY 7, 1998 PY - 2001 IS - PB2001-916501 AB - No abstract provided. KW - Crashes KW - Natural gas pipelines KW - Pipelines KW - Safety KW - South riding KW - Virginia UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0101.pdf UR - https://trid.trb.org/view/585452 ER - TY - JOUR AN - 00911496 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - DAVIS, DEBORAH AU - ACCIDENTS, AIRCRAFT AU - Follette, William C AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FOIBLES OF WITNESS MEMORY FOR TRAUMATIC/HIGH PROFILE EVENTS. PY - 2001 AB - No abstract provided. KW - Memory KW - Psychology KW - Witnesses UR - https://trid.trb.org/view/589111 ER - TY - JOUR AN - 00911498 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - ROLF, TROY A AU - Federal Aviation Administration AU - National Transportation Safety Board TI - TAXING THE CEO'S JET: FEDERAL TAXATION OF CORPORATE AND PRIVATE AIRCRAFT OWNERSHIP AND OPERATIONS. T2 - FEDERAL TAXATION OF CORPORATE AND PRIVATE AIRCRAFT OWNERSHIP AND OPERATIONS PY - 2001 AB - No abstract provided. KW - Jet propelled aircraft KW - Taxation KW - United States UR - https://trid.trb.org/view/589113 ER - TY - JOUR AN - 00911493 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - Abeyratne, Ruwantissa AU - Federal Aviation Administration AU - National Transportation Safety Board TI - E-COMMERCE AND THE AIRLINE PASSENGER. PY - 2001 AB - No abstract provided. KW - Air transportation KW - Electronic commerce KW - Laws and legislation UR - https://trid.trb.org/view/589109 ER - TY - JOUR AN - 00911492 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - BALILES, GERALD L AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AIRCRAFT NOISE: REMOVING A BARRIER TO AVIATION GROWTH. PY - 2001 AB - No abstract provided. KW - Abatement KW - Aircraft KW - Noise KW - Pollution control UR - https://trid.trb.org/view/589108 ER - TY - JOUR AN - 00911494 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - BENSON, BARRY F AU - ROSA, JILL DAHLMANN AU - Federal Aviation Administration AU - National Transportation Safety Board TI - THE STATUS OF PENDING AIR CARRIER LITIGATION. PY - 2001 AB - No abstract provided. KW - Air transportation KW - Airlines KW - Litigation UR - https://trid.trb.org/view/589110 ER - TY - JOUR AN - 00911497 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - KARP, JUDITH R AU - Federal Aviation Administration AU - National Transportation Safety Board TI - MILE HIGH ASSAULTS: AIR CARRIER LIABILITY UNDER THE WARSAW CONVENTION. PY - 2001 AB - No abstract provided. KW - Aggression KW - Air rage KW - Assault and battery KW - Crimes aboard aircraft KW - Indecent assault KW - Laws and legislation KW - Violent crimes UR - https://trid.trb.org/view/589112 ER - TY - JOUR AN - 00911499 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - HALL, JULIA AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AIR TRAVEL FROM THE PERSPECTIVE OF A CHILD: WHY DID MY MOTHER PAY FOR THIS?. PY - 2001 AB - No abstract provided. KW - Air transportation KW - Air travel KW - Children KW - Travel UR - https://trid.trb.org/view/589114 ER - TY - JOUR AN - 00906757 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - NORTON, DAVID T AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CRISIS MANAGEMENT PLANNING FOR SMALL AIR CARRIERS, AIRCRAFT PARTS MANUFACTURERS, INSTALLERS OR MAINTAINERS, AND OTHER AVIATION INDUSTRY PARTICIPANTS. PY - 2001 AB - No abstract provided. KW - Air transportation crashes KW - Crisis management KW - Liability UR - https://trid.trb.org/view/622970 ER - TY - JOUR AN - 00906759 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - CARLISLE, LEA ANN AU - Federal Aviation Administration AU - National Transportation Safety Board TI - THE FAA V. THE NTSB: NOW THAT CONGRESS HAS ADDRESSED THE FEDERAL AVIATION ADMINISTRATION'S "DUAL MANDATE," HAS THE FAA BEGUN LIVING UP TO ITS AMENDED PURPOSE OF MAKING AIR TRAVEL SAFER, OR IS THE NATIONAL TRANSPORTATION SAFETY BOARD STILL DOING ITS JOB ALONE?. PY - 2001 AB - No abstract provided. KW - Aeronautics KW - Safety KW - United States UR - https://trid.trb.org/view/622972 ER - TY - JOUR AN - 00906758 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - BOHMANN, KIRSTEN AU - Federal Aviation Administration AU - National Transportation Safety Board TI - THE OWNERSHIP AND CONTROL REQUIREMENT IN U.S. AND EUROPEAN UNION AIR LAW AND U.S. MARITIME LAW: POLICY, CONSIDERATION, COMPARISON. PY - 2001 AB - No abstract provided. KW - Air transportation policy KW - Airlines KW - Europe KW - United States UR - https://trid.trb.org/view/622971 ER - TY - JOUR AN - 00906760 JO - Journal of Air Law and Commerce PB - SMU Law Review Association AU - KEY, CHAD AU - Federal Aviation Administration AU - National Transportation Safety Board TI - GENERAL AVIATION IN THE NEW MILLENIUM: PROMISING REBIRTH - OR IMMINENT EXTINCTION?. PY - 2001 AB - No abstract provided. KW - Aeronautics KW - Private flying UR - https://trid.trb.org/view/622973 ER - TY - RPRT AN - 00821078 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-33 PY - 2000/11/21 SP - 3 p. AB - This safety recommendation, addressed to Mr. Walter B. McCormick, Jr., President and Chief Executive Officer, American Trucking Associations, and Mr. Steve Campbell, Executive Director, Commercial Vehicle Safety Alliance, recommends that the Maintenance Council of the American Trucking Associations and the Commercial Vehicle Safety Alliance advise their members of the importance of requiring a brake application during inspections of tractor protection systems and the consequences of not doing so, as evidenced by the circumstances of the October 21, 1999, accident in Central Bridge, New York (H-00-33). KW - Brakes KW - Commercial vehicles KW - Inspection KW - Recommendations KW - Tractor protection system UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_33.pdf UR - https://trid.trb.org/view/712628 ER - TY - RPRT AN - 00821077 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-31 AND -32 PY - 2000/11/21 SP - 4 p. AB - This safety recommendation, addressed to Mr. Charlie Gauthier, Executive Director, National Association of State Directors of Pupil Transportation Services, recommends that the National Association of State Directors of Pupil Transportation Services inform its members of the potential for injury to passengers from protruding door handles or latching mechanisms on emergency exit doors and consider not placing passengers in those seat positions adjacent to emergency exit doors so equipped (H-00-31), and inform its members again of the safety hazards of not ensuring that the seat cushion bottom latching clips are properly latched at all times (H-00-32). KW - Door handles KW - Door latches KW - Emergency exits KW - Hazards KW - Latching clips KW - Recommendations KW - School buses KW - Seat cushions KW - Seating position UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_31_32.pdf UR - https://trid.trb.org/view/712627 ER - TY - RPRT AN - 00821075 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-28 AND -29 PY - 2000/11/21 SP - 4 p. AB - This safety recommendation, addressed to Dr. Sue Bailey, Administrator, National Highway Traffic Safety Administration (NHTSA), recommends that NHTSA modify the Federal Motor Vehicle Safety Standards (FMVSS) to prohibit protruding door handles or latching mechanisms on emergency exit doors (H-00-28) and modify the FMVSS to include the requirement that school bus seat cushion bottoms be installed with fail-safe latching devices to ensure they remain in their installed position during impacts and rollovers (H-00-29). KW - Door handles KW - Door latches KW - Emergency exits KW - Fail-safe latching devices KW - Federal Motor Vehicle Safety Standards KW - Recommendations KW - School buses KW - Seat cushions UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_28_29.pdf UR - https://trid.trb.org/view/712625 ER - TY - RPRT AN - 00821076 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-30 PY - 2000/11/21 SP - 3 p. AB - This safety recommendation, addressed to Ms. Julie Cirillo, Acting Assistant Administrator and Chief Safety Officer, Federal Motor Carrier Safety Administration (FMCSA), recommends that the FMCSA advise relevant staff of the importance of requiring a brake application during inspections of tractor protection systems and the consequences of not doing so, as evidenced by the circumstances of the October 21, 1999, accident in Central Bridge, New York (H-00-30). KW - Brakes KW - Commercial vehicles KW - Inspection KW - Recommendations KW - Tractor protection system UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_30.pdf UR - https://trid.trb.org/view/712626 ER - TY - RPRT AN - 00806966 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: SCHOOL BUS AND DUMP TRUCK COLLISION, CENTRAL BRIDGE, NEW YORK, OCTOBER 21, 1999 PY - 2000/11/14 SP - 43 p. AB - On October 21, 1999, about 10:30 a.m. near Central Bridge, New York, a school bus was transporting 44 students and 8 adults on a field trip. The bus was traveling north on State Route 30A as it approached the intersection with State Route 7. Concurrently, a dump truck, towing a utility trailer, was traveling west on State Route 7. As the bus approached the intersection, it failed to stop as required and was struck by the dump truck. Seven bus passengers sustained serious injuries; 28 bus passengers and the truck driver received minor injuries. Thirteen bus passengers, the bus driver, and the truck passenger were uninjured. The major safety issues discussed in this report are potential for passenger injuries as a result of the school bus emergency exit door design, the potential for passenger injuries as a result of school bus seat cushion bottoms that are removable or hinged, and the adequacy of commercial vehicle airbrake inspections. As a result of this accident investigation, the Safety Board issued recommendations to the National Highway Traffic Safety Administration, the Federal Motor Carrier Safety Administration, the National Association of State Directors of Pupil Transportation Services, the Maintenance Council of the American Trucking Associations, and the Commercial Vehicle Safety Alliance. In addition, safety recommendations were reiterated to the National Highway Traffic Safety Administration. KW - Air brakes KW - Bus crashes KW - Bus drivers KW - Commercial vehicles KW - Crash investigation KW - Driver errors KW - Dump trucks KW - Emergency exit door (Buses) KW - Injuries KW - Injury severity KW - Inspection KW - Interior design KW - Loss and damage KW - Recommendations KW - School buses KW - Seat cushion bottoms KW - Truck crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0002.pdf UR - https://trid.trb.org/view/672905 ER - TY - RPRT AN - 01003092 AU - National Transportation Safety Board TI - Marine Accident Report: Ramming of the Eads Bridge by Barges in Tow of the M/V Anne Holly with Subsequent Ramming and Near Breakaway of the President Casino on the Admiral, St. Louis Harbor, Missouri, April 4, 1998 PY - 2000/09/08 SP - 118p AB - About 1950 on April 4, 1998, a tow of the M/V Anne Holly, comprising 14 barges, which was traveling northbound on the Mississippi River through the St. Louis Harbor, struck the Missouri-side pier of the center span of the Eads Bridge. Eight barges broke away from the tow and drifted back through the span. Three of these drifting barges struck the President Casino on the Admiral (Admiral), a permanently moored gaming vessel below the bridge, causing most of its mooring lines to break. The Admiral then rotated away from the riverbank. The captain of the Anne Holly placed its bow against the Admiral’s bow to hold the Admiral with its single remaining mooring wire against the bank. Fifty people were examined for minor injuries and 16 were sent to hospitals for further treatment. Damages were estimated at $11 million. The National Transportation Safety Board determines that the probable cause of the ramming of the Eads Bridge by barges in tow of the Anne Holly and the subsequent breakup of the tow was the poor decision-making of the captain of the Anne Holly in attempting to transit St. Louis Harbor with a large tow, in darkness, under high current and flood conditions, and the failure of the management of American Milling, L.P., to provide adequate policy and direction to ensure the safe operation of its towboats. The NTSB also determines that the probable cause of the near breakaway of the Admiral was the failure of the owner, the local and State authorities, and the U.S. Coast Guard to adequately protect the permanently moored vessel from waterborne and current-related risks. The Safety Board’s investigation identified the following major safety issues: (1) the advisability of the Anne Holly captain’s decision to make the upriver transit and the effectiveness of safety management oversight on the part of American Milling, L.P.; (2) the effectiveness of safety measures provided for the Admiral; and (3) the adequacy of public safety for permanently moored vessels. KW - Barges KW - Crash causes KW - Crash investigation KW - Crash reports KW - Eads Bridge (Missouri) KW - Injuries KW - Loss and damage KW - Maritime safety KW - Mississippi River KW - Moored structures KW - Oversight KW - Recommendations KW - Safety management KW - Saint Louis (Missouri) KW - Ship pilotage KW - Towboats KW - Water transportation crashes UR - http://ntl.bts.gov/lib/17000/17100/17155/PB2000916401.pdf UR - https://trid.trb.org/view/759303 ER - TY - RPRT AN - 00808582 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT BREAKUP OVER THE ATLANTIC OCEAN, TRANS WORLD AIRLINES FLIGHT 800, BOEING 747-131, N93119, NEAR EAST MORICHES, NEW YORK, JULY 17, 1996 PY - 2000/08/23 SP - 441 p. AB - This report explains the accident involving Trans World Airlines, Inc., flight 800, which experienced an in-flight breakup and then crashed into the Atlantic Ocean near East Moriches, New York, on July 17, 1996. Safety issues in the report focus on fuel tank flammability, fuel tank ignition sources, design and certification standards, and the maintenance and aging of aircraft systems. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration. KW - Aging (Materials) KW - Air transportation crashes KW - Aircraft KW - Atlantic Ocean KW - Boeing 747 aircraft KW - Certification KW - Crash reports KW - Design standards KW - Flammability KW - Fuel tanks KW - Ignition KW - Inflight breakup KW - Maintenance practices KW - Trans World Airlines UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0003.pdf UR - https://trid.trb.org/view/673386 ER - TY - RPRT AN - 00821047 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-27 PY - 2000/08/07 SP - 6 p. AB - This safety recommendation, addressed to the Honorable Rodney E. Slater, Secretary, U.S. Department of Transportation (DOT), recommends that the DOT evaluate modifications to the provisions of the Transportation Equity Act for the 21st Century so that it can be more effective in assisting the States to reduce the hardcore drinking driver problem and recommend changes to Congress as appropriate. Considerations should include (a) a revised definition of "repeat offender" to include administrative actions on driving while intoxicated (DWI) offenses; (b) mandatory treatment for hard core offenders; (c) a minimum period of 10 years for records retention and DWI offense enhancement; (d) administratively imposed vehicle sanctions for hard core drinking drivers; (e) elimination of community service as an alternative to incarceration; and (f) inclusion of home detention with electronic monitoring as an alternative to incarceration. KW - Definitions KW - Drunk driving KW - Hard core offenders KW - Home detention with electronic monitoring KW - Incarceration KW - Mandatory treatment KW - Recommendations KW - Records management KW - Repeat offenders KW - Revisions KW - Sanctions KW - Transportation Equity Act for the 21st Century KW - U.S. National Highway Traffic Safety Administration UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_27.pdf UR - https://trid.trb.org/view/712588 ER - TY - RPRT AN - 00821048 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-26 PY - 2000/08/07 SP - 5 p. AB - This safety recommendation, addressed to the Governors and Legislative leaders of the 50 States and the Mayor and Council of the District of Columbia, recommends that they establish a comprehensive program that is designed to reduce the incidence of alcohol-related crashes and fatalities caused by hard core drinking drivers and that includes elements such as those suggested in the National Transportation Safety Board's Model Program. KW - Countermeasures KW - Drunk drivers KW - Drunk driving KW - Recommendations KW - Repeat offenders KW - Safety programs KW - States UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_26.pdf UR - https://trid.trb.org/view/712589 ER - TY - RPRT AN - 00806965 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CRASH DURING LANDING, FEDERAL EXPRESS, INC., MCDONNELL DOUGLAS MD-11, N611FE, NEWARK INTERNATIONAL AIRPORT, NEWARK, NEW JERSEY, JULY 31, 1997 PY - 2000/07/25 SP - 112 p. AB - This report explains the accident involving Federal Express flight 14, an MD-11, which crashed while landing on runway 22R at Newark International Airport, Newark, New Jersey, on July 31, 1997. Safety issues discussed in this report focus on landing techniques, bounced landing recovery, and training tools and policies that promote proactive decision-making to go around if an approach is unstabilized. Safety issues also include the use of on board computers to determine the required runway length for landing, MD-11 handling characteristics and structural integrity requirements, hard landing inspection requirements, and tracking hazardous materials. KW - Air transportation crashes KW - Hard landing accidents KW - Hazardous materials KW - Inspection KW - Landing KW - McDonnell Douglas MD-11 KW - Newark Liberty International Airport KW - Structural integrity UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0002.pdf UR - https://trid.trb.org/view/672904 ER - TY - RPRT AN - 00806968 AU - National Transportation Safety Board TI - SAFETY REPORT: ACTIONS TO REDUCE FATALITIES, INJURIES, AND CRASHES INVOLVING THE HARD CORE DRINKING DRIVER PY - 2000/06/27 SP - 92 p. AB - From 1983 through 1998, at least 137,338 people died and 99,812 people were injured in fatal crashes involving hard core drinking drivers, a term used in this report to include repeat offender drinking drivers as well as offenders with high blood-alcohol concentrations. In 1998 alone, hard core drinking drivers were involved in a minimum of 6,370 highway fatalities, the estimated cost of which was at least $5.3 billion. The safety issue discussed in this report is the roadway risk presented by hard core drinking drivers. The report discusses research on control measures used in one or more of the States and proposes solutions. It also discusses steps taken by the United States Congress to address the hard core drinking driver problem by enacting certain provisions in the Transportation Equity Act for the 21st Century (TEA-21), and suggests ways to make this legislation even more effective. As a result of its study, the National Transportation Safety Board issued recommendations to the Governors and Legislative Leaders of the 50 States and the Mayor and Council of the District of Columbia, and to the Department of Transportation. KW - Blood alcohol levels KW - Countermeasures KW - Drunk drivers KW - Fatalities KW - Injuries KW - Recommendations KW - Repeat offenders KW - Risk analysis KW - States KW - Traffic crashes KW - Transportation Equity Act for the 21st Century KW - United States Congress UR - http://ntl.bts.gov/lib/17000/17100/17173/PB2000917003.pdf UR - https://trid.trb.org/view/672907 ER - TY - RPRT AN - 00804943 AU - National Transportation Safety Board TI - SAFETY STUDY: EMERGENCY EVACUATION OF COMMERCIAL AIRPLANES PY - 2000/06/27 SP - 491 p. AB - Since its inception, the National Transportation Safety Board has been concerned about the evacuation of commercial airplanes in the event of an emergency. Several accidents investigated by the Safety Board in the last decade that involved emergency evacuations prompted the Safety Board to conduct a study on the evacuation of commercial airplanes. The study described in this report is the first prospective study of emergency evacuation of commercial airplanes. For the study, the Safety Board investigated 46 evacuations that occurred between September 1997 and June 1999 that involved 2,651 passengers. Eighteen different aircraft types were represented in the study. Based on information collected from the passengers, the flight attendants, the flight crews, the air carriers, and the aircraft rescue and fire fighting (ARFF) units, the Safety Board examined the following safety issues in the study: (a) certification issues related to airplane evacuation, (b) the effectiveness of evacuation equipment, (c) the adequacy of air carrier and ARFF guidance and procedures related to evacuations, and (d) communication issues related to evacuations. The study also compiled some general statistics on evacuations, including the number of evacuations and the types and number of passenger injuries incurred during evacuations. As a result of the study, the National Transportation Safety Board issued 20 safety recommendations and reiterated 3 safety recommendations to the Federal Aviation Administration. KW - Air transportation crashes KW - Airplanes KW - Aviation safety KW - Certification KW - Civil aviation KW - Communication KW - Emergencies KW - Equipment KW - Evacuation KW - Injuries KW - Procedures KW - Statistics KW - U.S. National Transportation Safety Board UR - http://libraryonline.erau.edu/online-full-text/ntsb/safety-studies/SS00-01.pdf UR - https://trid.trb.org/view/672165 ER - TY - RPRT AN - 01139256 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Chemical Reactions During Cargo Transfer, Whitehall, Michigan, June 4, 1999 PY - 2000/06/20 SP - 11p AB - About 3:30 a.m. on June 4, 1999, a Quality Carriers, Inc., truckdriver arrived at the Whitehall Leather Company tannery in Whitehall, Michigan, to deliver a load of sodium hydrosulfide solution. The truckdriver had never been to the plant before. Upon arrival, he asked a tannery employee for assistance. The employee called the shift supervisor, who met the driver at the plant employee's work station. The shift supervisor stated that the only chemical shipment he had previously received on the third shift was "pickle acid" (ferrous sulfate). He said he had not been told to expect the delivery of another chemical on the shift, so he assumed this load was also pickle acid. The supervisor stated that because the driver did not know the plant's layout and was unfamiliar with where to unload his cargo, he walked the driver through the plant and out to the pickle acid transfer area. The supervisor did not verify what chemical was being delivered. The shipping documents identified the cargo as sodium hydrosulfide solution. The shift supervisor showed the driver the ferrous sulfate connection (the only working transfer connection at that location) so he could deliver his product. The shift supervisor then unlocked a gate to allow the driver to bring his vehicle onto the plant property. The driver asked the supervisor to sign the shipping documents so he would not have to find the supervisor after the transfer was completed. According to the supervisor, he signed the paperwork without reading it and left the area. The signature block that the supervisor signed stated the following: "I have checked the documents for this shipment and verify that there is adequate storage room to receive this shipment and connection has been made to the proper storage facility." About 4 a.m., an employee in the basement of the tannery building smelled a pungent odor and lost consciousness. The employee said that after regaining consciousness about 10 minutes later, he made his way out of the tannery to an area adjacent to the south parking lot, where he found other employees on break. One of these employees called 911. The driver was found unconscious inside the tannery building approximately 230 feet from the transfer area. He was pronounced dead at the scene and was later determined to have been overcome by hydrogen sulfide gas. No telephone or other means of communication was located near the transfer area that the driver could have used to notify plant personnel of an emergency. Postaccident investigation revealed that both the emergency valve at the rear of the cargo tank and the compressed air valve, located inside the tannery building approximately 40 feet from the transfer area, were closed and secured. The National Transportation Safety Board determines that the probable cause of this accident was the failure of Whitehall Leather Company to have adequate unloading procedures, practices, and management controls in place to ensure the safe delivery of chemicals to storage tanks. Contributing to the accident was the failure of the U.S. Department of Transportation to establish, and oversee compliance with, adequate safety requirements for unloading hazardous materials from highway cargo tanks. No plant employees were in the vicinity of the transfer area. When the driver arrived at the transfer area, a transfer hose was already connected to a pipe, marked "FERROUS SULFATE," on the side of the transfer building. During the postaccident investigation, investigators found the other end of the transfer hose connected to the cargo tank and determined that sodium hydrosulfide solution had been transferred from the cargo tank into the storage tank containing ferrous sulfate. (Sodium hydrosulfide solution reacts with ferrous sulfate solution to produce hydrogen sulfide, a poisonous gas.) KW - Cargo handling KW - Cargo transfer KW - Chemical reactions KW - Crash causes KW - Crash investigation KW - Hazardous materials KW - Hazardous materials accidents UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB0003.pdf UR - https://trid.trb.org/view/898519 ER - TY - RPRT AN - 01139234 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Chemical Reactions During Cargo Transfer, Louisville, Kentucky, November 19, 1998 PY - 2000/06/20 SP - 9p AB - About 7:15 a.m. eastern standard time on November 19, 1998, a truckdriver driving a Matlack, Inc., cargo tank truck arrived at Ford Motor Company's Kentucky Truck Plant in Louisville, Kentucky, to deliver a liquid mixture of nickel nitrate and phosphoric acid (a solution designated CHEMFOS 700 by the shipper). A plant employee told the truckdriver to park his vehicle next to the chemical transfer station outside the bulk storage building and wait for a pipefitter to assist him in unloading the chemical. According to testimony, a short time later, the pipefitter arrived at the transfer station and told the driver that he would assist him in unloading the cargo tank. The pipefitter opened an access panel containing six identical pipe connections. Each pipe connection served a different storage tank, and each connection was marked with the plant's designation for the chemical stored in that tank. The driver told the pipefitter that he was delivering CHEMFOS 700 and then went to the driver's side of the cargo tank and took out a cargo transfer hose. The pipefitter connected one end of the hose to one of the transfer couplers, while the driver connected the other end of the hose to the cargo tank's discharge fitting. Unknown to the pipefitter or the truckdriver, the pipefitter had inadvertently attached the hose to the coupler marked "CHEMFOS LIQ. ADD" instead of to the adjacent coupler marked "CHEMFOS 700." The storage tank served by the coupler marked "CHEMFOS LIQ. ADD" contained sodium nitrite solution. The driver climbed to the top of the cargo tank, connected a compressed air hose to a fitting, and pressurized the cargo tank. The driver and the pipefitter then reviewed the cargo manifest and bill of lading. The pipefitter signed three different certifications on the cargo manifest, one of which certified that the transfer hose was "connected to the proper receiving line." The pipefitter asked the driver how long it would take to unload the contents of the cargo tank, and the driver told him the transfer would take about 30 to 40 minutes. The pipefitter then left the loading area, leaving the driver to complete the unloading by himself. About 8:15 a.m., after the air pressure was built up in the cargo tank, the truckdriver started the transfer. When the nickel nitrate and phosphoric acid solution from the truck mixed with the sodium nitrite solution in the storage tank, a chemical reaction occurred that produced toxic gases of nitric oxide and nitrogen dioxide. The driver stated that about 10 minutes after he started the transfer, he saw an orange cloud coming from the bulk storage building. He said he closed the internal valve of the cargo tank to stop the transfer of cargo and waited for someone to come out of the building. After several minutes, the pipefitter ran out of the building and gestured for the driver to stop the unloading process. As a result of the incident, about 2,400 people were evacuated from the plant and surrounding businesses, and another 600 local residents were told by authorities to remain inside their homes. Three police officers, three Ford Motor Company employees, and the truckdriver were treated for minor inhalation injuries. Damages exceeded $192,000. KW - Cargo handling KW - Cargo transfer KW - Chemical reactions KW - Crash causes KW - Crash investigation KW - Hazardous materials KW - Hazardous materials accidents UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB0002.pdf UR - https://trid.trb.org/view/898518 ER - TY - RPRT AN - 01139267 AU - National Transportation Safety Board TI - Hazardous Materials Incident Brief: Spill of an Undeclared Shipment of Hazardous Materials in a Cargo Compartment of an Aircraft Northwest Airlines Flight 957, October 28, 1998 PY - 2000/05/17 SP - 11p AB - On the morning of October 28, 1998, 2 gallons of a 35-percent hydrogen peroxide solution in water, an oxidizer with corrosive properties, spilled in a cargo compartment of Northwest Airlines (Northwest) flight 957, a passenger-carrying airplane en route from Orlando, Florida, to Memphis, Tennessee. The solution leaked from two undeclared 1-gallon plastic bottles that had split. The bottles were in an ice chest that belonged to a passenger on the flight. The leaking hydrogen peroxide contaminated three mail sacks and an undetermined number of bags. The leak was not discovered until cargo handlers in Memphis began to unload the baggage on flight 957. Thinking that the spilled liquid was water, the cargo handlers ignored it and transferred some of the baggage to other Northwest passenger-carrying flights, including flight 7, which then departed for Seattle, Washington. When flight 7 arrived in Seattle, two bags in a cargo compartment were smoldering, including one that had come from flight 957. As a result of the spill, several people required treatment. In Memphis, 11 employees were treated at the airport's first aid station because their hands had been exposed to the hydrogen peroxide, and 2 more employees went to a local clinic, where they were treated and released. In Seattle, the employee who removed the smoldering bags from the cargo compartment was exposed to fumes. He went to a hospital for treatment and was released. None of the injuries were serious. Northwest estimated that the total cost of the damage to and the downtime on the aircraft and of the damage to the baggage was more than $40,000. The National Transportation Safety Board determines that the probable cause of the release of undeclared hazardous material aboard Northwest Airlines flight 957 was the passenger's failure to properly package and identify the hazardous material and inadequate inquiries from the Northwest Airlines agent about the contents of the cooler offered by the passenger. Contributing to the consequences of the release were inadequate carrier procedures, which allowed contaminated baggage to be transferred to other aircraft. KW - Aircraft incidents KW - Crash causes KW - Crash investigation KW - Hazardous materials KW - Spills (Pollution) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB0001.pdf UR - https://trid.trb.org/view/898517 ER - TY - RPRT AN - 00806967 AU - National Transportation Safety Board TI - HIGHWAY SPECIAL INVESTIGATION REPORT: TRUCK PARKING AREAS PY - 2000/05/17 SP - 39 p. AB - In April 1999, the National Transportation Safety Board began a Truck/Bus Safety Initiative and to date has held four public hearings to obtain information from a variety of sources about the relevant safety issues regarding trucks and buses and on how to address them. Participating in these hearings were representatives from the truck and bus industries, vehicle and equipment manufacturers, labor unions, safety advocacy groups, and various State and Federal agencies. The major issues addressed in this Safety Board special investigation report is the lack of safe available commercial vehicle parking on or near interstates for truck drivers who want or need to use it. Associated with this issue, this report also discusses the lack of information about parking available to truck drivers and the State-enforced parking time limits. As a result of its investigation, the Safety Board issued recommendations to the Federal Highway Administration; the Federal Motor Carrier Safety Administration; the Governors of Alabama, Delaware, Florida, Georgia, Illinois, Kentucky, Louisiana, Minnesota, Nebraska, New Jersey, Pennsylvania, South Carolina, South Dakota, Tennessee, Virginia, and Washington; the American Trucking Associations, Inc.; the Owner-Operator Independent Drivers Association; the National Private Truck Council; the National Association of Truck Stop Operators; and the National Industrial Transportation League. KW - Commercial vehicles KW - Information dissemination KW - Interstate highways KW - Parking facilities KW - Roadside rest areas KW - Time limits (Public rest areas) KW - Trucking safety UR - http://ntl.bts.gov/lib/17000/17100/17171/PB2000917001.pdf UR - https://trid.trb.org/view/672906 ER - TY - RPRT AN - 00796974 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-11 PY - 2000/01/14 SP - 4 p. AB - This safety recommendation, addressed to Mr. Peter J. Pantuso, President and Chief Executive Officer, American Bus Association, recommends that the American Bus Association: Advise its members of the facts and circumstances of the accident on June 20, 1998 near Burnt Cabins, Huntingdon County, Pennsylvania, and encourage them, if they do not already do so, to 1) revise their driver scheduling practices to reduce scheduling variability that results in irregular work-rest cycles and to 2) include all traffic violations in their drivers' records and consider these violations during driver safety assessments (H-00-11). KW - American Bus Association KW - Bus drivers KW - Driver assessments KW - Hours of labor KW - Intercity bus lines KW - Recommendations KW - Scheduling KW - Traffic violations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_11.pdf UR - https://trid.trb.org/view/654707 ER - TY - RPRT AN - 00796972 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-06 THROUGH H-00-09 PY - 2000/01/14 SP - 6 p. AB - This safety recommendation, addressed to Mr. Jack Haugsland, Chief Operating Officer, Greyhound Lines, Inc., recommends that Greyhound Lines, Inc.: (1) Revise their driver scheduling practices to reduce scheduling variability that results in irregular work-rest cycles (H-00-06); (2) Include in their drivers' assessment programs all driver traffic and log book violations (H-00-07); (3) Use all current and future data monitoring and storage capabilities of electronic control modules, electronic control units, and similar technologies to enhance vehicle and driver oversight programs by engaging the specific capabilities of each individual unit's programmed or programmable functions to collect and monitor data including, but not limited to, vehicle speed, revolutions-per-minute, hard-brake or sudden decelerations, and other parameters of vehicle and engine operations (H-00-08); and (4) Revise their 1-800-SAFEBUS program to ensure that all complaints are included in drivers' files and used in drivers' assessments (H-00-09). KW - Bus drivers KW - Complaints KW - Data collection KW - Driver assessments KW - Electronics KW - Greyhound Lines KW - Hours of labor KW - Intercity bus lines KW - Monitoring KW - Recommendations KW - Scheduling KW - Traffic violations UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_06_09.pdf UR - https://trid.trb.org/view/654705 ER - TY - RPRT AN - 00796970 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-01 AND H-00-02 PY - 2000/01/14 SP - 3 p. AB - This safety recommendation, addressed to Ms. Rosalyn G. Millman, Acting Administrator, National Highway Traffic Safety Administration (NHTSA), recommends that the NHTSA: (1) Revise the Federal Motor Vehicle Safety Standards (FMVSS) to require that all motorcoaches be equipped with emergency lighting fixtures that are outfitted with a self-contained independent power source (H-00-01); and (2) Revise the FMVSS to require the use of interior luminescent or exterior retroreflective material or both to mark all emergency exits in all motor coaches (H-00-02). KW - Buses KW - Emergency exits KW - Emergency lighting KW - Federal Motor Vehicle Safety Standards KW - Intercity bus lines KW - Luminous materials KW - Recommendations KW - Retroreflectors KW - Revisions UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_01_02.pdf UR - https://trid.trb.org/view/654703 ER - TY - RPRT AN - 00796971 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-03 THROUGH H-00-05 PY - 2000/01/14 SP - 4 p. AB - This safety recommendation, addressed to Mr. John F. Malone, III, Chairman, Pennsylvania Turnpike Commission, recommends that the Pennsylvania Turnpike Commission: (1) Prohibit nonemergency parking in pull-off areas within the highway clear zone (H-00-03); (2) Provide adequate rest areas for nonemergency parking to accommodate vehicles that may be displaced by the prohibition of parking in emergency pull-off areas within the highway clear zone (H-00-04); and (3) Periodically conduct disaster drills in mass casualty transportation accidents, such as the bus accident near Burnt Cabins, with contracted emergency response departments on the Pennsylvania Turnpike to assess its emergency management plan, to reinforce and evaluate emergency training, and to test communication among the responding agencies (H-00-05). KW - Clear zones KW - Disaster preparedness KW - Emergency communication systems KW - Emergency training KW - No parking KW - Pennsylvania Turnpike Commission KW - Recommendations KW - Roadside rest areas UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_03_05.pdf UR - https://trid.trb.org/view/654704 ER - TY - RPRT AN - 00796973 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-10 PY - 2000/01/14 SP - 4 p. AB - This safety recommendation, addressed to Mr. Victor S. Parra, Executive Director and Chief Operating Officer, United Motorcoach Association, recommends that the United Motorcoach Association: Advise its members of the facts and circumstances of the accident on June 20, 1998 near Burnt Cabins, Huntingdon County, Pennsylvania and encourage them, if they do not already do so, to 1) revise their driver scheduling practices to reduce scheduling variability that results in irregular work-rest cycles and to 2) include all traffic violations in their drivers' records and consider these violations during driver safety assessments (H-00-10). KW - Bus drivers KW - Driver assessments KW - Hours of labor KW - Intercity bus lines KW - Recommendations KW - Scheduling KW - Traffic violations KW - United Motorcoach Association UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_10.pdf UR - https://trid.trb.org/view/654706 ER - TY - RPRT AN - 00796975 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-00-12 THROUGH H-00-15 PY - 2000/01/13 SP - 26 p. AB - This safety recommendation, addressed to Ms. Julie Anna Cirillo, Acting Deputy Administrator, Federal Motor Carrier Safety Administration (FMCSA), recommends that the FMCSA: (1) Establish, with assistance from experts on the effects of pharmacological agents on human performance and alertness, procedures or criteria by which highway vehicle operators who medically require substances not on the U.S. Department of Transportation's list of approved medications may be allowed, when appropriate, to use those medications when driving (H-00-12); (2) Develop, then periodically publish, an easy-to-understand source of information for highway vehicle operators on the hazards of using specific medications when driving (H-00-13); (3) Establish and implement an education program targeting highway vehicle operators that, at a minimum, ensures that all operators are aware of the source of information described in Safety Recommendation H-00-13 regarding the hazards of using specific medications when driving (H-00-14); and (4) Establish, in coordination with the U.S. Department of Transportation, the Federal Railroad Administration, the Federal Transit Administration, and the U.S. Coast Guard, comprehensive toxicological testing requirements for an appropriate sample of fatal highway, railroad, transit, and marine accidents to ensure the identification of the role played by common prescription and over-the-counter medications; and review and analyze the results of such testing at intervals not to exceed every 5 years (H-00-15). KW - Education KW - Fatalities KW - Highway vehicle operators KW - Information dissemination KW - Medication KW - Recommendations KW - Testing KW - Toxicology KW - U.S. Federal Motor Carrier Safety Administration UR - http://www.ntsb.gov/safety/safety-recs/recletters/H00_12_15.pdf UR - https://trid.trb.org/view/654708 ER - TY - RPRT AN - 00796977 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, I-00-5 PY - 2000/01/13 SP - 26 p. AB - This safety recommendation, addressed to the Honorable Jane E. Henney, M.D., Commissioner, U.S. Food and Drug Administration (FDA), recommends that the FDA: Establish a clear, consistent, easily recognizable warning label for all prescription and over-the-counter medications that may interfere with an individual's ability to operate a vehicle; and require that the label be prominently displayed on all packaging of such medications (I-00-5). KW - Labeling KW - Medication KW - Recommendations KW - Transportation safety KW - U.S. Food and Drug Administration UR - http://www.ntsb.gov/safety/safety-recs/recletters/I00_5.pdf UR - https://trid.trb.org/view/654710 ER - TY - RPRT AN - 00796976 AU - HALL, J AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, I-00-1 THROUGH I-00-4 PY - 2000/01/13 SP - 26 p. AB - This safety recommendation, addressed to the Honorable Rodney E. Slater, Secretary, U.S. Department of Transportation (DOT), recommends that the DOT: (1) Establish, in coordination with the Federal Motor Carrier Safety Administration (FMCSA), the Federal Railroad Administration (FRA), the Federal Transit Administration (FTA), and the U.S. Coast Guard, comprehensive toxicological testing requirements for an appropriate sample of fatal highway, railroad, transit, and marine accidents to ensure the identification of the role played by common prescription and over-the-counter medications; and review and analyze the results of such testing at intervals not to exceed every 5 years (I-00-1); (2) Develop, with assistance from experts on the effects of pharmacological agents on human performance and alertness, a list of approved medications and/or classes of medications that may be used safely when operating a vehicle (I-00-2); (3) Expressly prohibit the use of any medication not on the DOT's list of approved medications (described in Safety Recommendation I-00-2) for twice the recommended dosing interval before or during vehicle operation, except as specifically allowed, when appropriate, by procedures or criteria established by the applicable modal administration (the Federal Aviation Administration, FMCSA, FRA, FTA, or the U.S. Coast Guard) (I-00-3); and (4) Evaluate the applicability of the restrictions (for vehicle operators) described in Safety Recommendations I-00-2 and I-00-3 to transportation employees in all safety-sensitive positions; and if appropriate, implement such restrictions within 2 years of their implementation for vehicle operators (I-00-4). KW - Air pilots KW - Fatalities KW - Ground vehicle operators KW - Medication KW - Recommendations KW - Regulations KW - Safety-sensitive positions (Transportation) KW - Ship pilots KW - Testing KW - Toxicology KW - U.S. Department of Transportation KW - U.S. Federal Aviation Administration KW - U.S. Federal Motor Carrier Safety Administration KW - U.S. Federal Railroad Administration KW - U.S. Federal Transit Administration KW - United States Coast Guard UR - http://www.ntsb.gov/safety/safety-recs/recletters/I00_1_4.pdf UR - https://trid.trb.org/view/654709 ER - TY - RPRT AN - 00790659 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: GREYHOUND MOTORCOACH RUN-OFF-THE-ROAD ACCIDENT. BURNT CABINS, PENNSYLVANIA. JUNE 20, 1998 PY - 2000/01/05 SP - 80 p. AB - About 4:05 a.m. on June 20, 1998, a 1997 Motor Coach Industries 47-passenger motorcoach, operated by Greyhound Lines, Inc., was on a scheduled trip from New York City to Pittsburgh, Pennsylvania, traveling westbound on the Pennsylvania Turnpike near Burnt Cabins, Huntingdon County, Pennsylvania. The bus traveled off the right side of the roadway into an emergency parking area, where it struck the back of a parked tractor-semitrailer, which was pushed forward and struck the left side of another parked tractor-semitrailer. Of the 23 people on board the bus, the driver and six passengers were killed; the other 16 passengers were injured. The two occupants of the first tractor-semitrailer were injured, and the occupant of the second tractor-semitrailer was uninjured. The National Transportation Safety Board (NTSB) determined that the probable cause of this accident was the bus driver's reduced alertness resulting from ingesting a sedating antihistamine and from his fatigued condition resulting from Greyhound scheduling irregular work-rest periods. Contributing to the severity of the accident was the Pennsylvania Turnpike Commission's practice of routinely permitting nonemergency parking in pull-off areas within the highway clear zone. The major safety issues identified in this accident were the bus driver's performance, the adequacy of carrier oversight, the adequacy of the design and the appropriateness of the use of pull-off areas, the lack of motorcoach emergency interior lighting and retroreflective signage, and the organization of the disaster preparedness and emergency response management. This report concludes with recommendations to the National Highway Traffic Safety Administration; the Pennsylvania Turnpike Commission; Greyhound Lines, Inc.; the United Motorcoach Association; and the American Bus Association made by NTSB as a result of the investigation. KW - Alertness KW - American Bus Association KW - Antihistamines KW - Burnt Cabins (Pennsylvania) KW - Bus crashes KW - Bus drivers KW - Bus transportation KW - Crash causes KW - Crash investigation KW - Crash severity KW - Emergency exits KW - Fatalities KW - Fatigue (Physiological condition) KW - Greyhound Lines KW - Highway traffic KW - Injuries KW - Parking facilities KW - Pennsylvania KW - Pennsylvania Turnpike Commission KW - Ran off road crashes KW - Recommendations KW - Tractor trailer combinations KW - Traffic crashes KW - U.S. National Transportation Safety Board KW - United Motorcoach Association UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR0001.pdf UR - http://ntl.bts.gov/lib/17000/17100/17153/PB2000916201.pdf UR - http://ntl.bts.gov/lib/9000/9700/9757/HAR0001.pdf UR - https://trid.trb.org/view/648316 ER - TY - RPRT AN - 00911253 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT DERAILMENT OF BURLINGTON NORTHERN AND SANTA FE RAILWAY COMPANY INTERMODAL FREIGHT TRAIN S-CHILAC1-31, CRISFIELD, KANSAS, SEPTEMBER 2, 1998 PY - 2000 IS - PB2000-916301 AB - No abstract provided. KW - Crisfield KW - Kansas KW - Railroad crashes KW - Railroads KW - United States UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR0001.pdf UR - https://trid.trb.org/view/585267 ER - TY - RPRT AN - 00911255 AU - National Transportation Safety Board TI - EMERGENCY EVACUATION OF COMMERCIAL AIRPLANES. PY - 2000 IS - NTSB/SS-00/01 AB - No abstract provided. KW - Air transportation KW - Aircraft cabins KW - Safety KW - Survival UR - http://ntl.bts.gov/lib/17000/17100/17172/PB2000917002.pdf UR - https://trid.trb.org/view/585269 ER - TY - RPRT AN - 00911254 AU - National Transportation Safety Board TI - NATURAL GAS PIPELINE RUPTURE AND SUBSEQUENT EXPLOSION, ST. CLOUD, MINNESOTA, DECEMBER 11, 1998 PY - 2000 IS - NTSB/PAR-00/01 AB - No abstract provided. KW - Crashes KW - Failure KW - Minnesota KW - Natural gas pipelines KW - Saint Cloud (Minnesota) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/PAR0001.pdf UR - https://trid.trb.org/view/585268 ER - TY - RPRT AN - 00805880 AU - National Transportation Safety Board TI - PUTTING CHILDREN FIRST PY - 2000 SP - 45 p. AB - This document focuses on what has been and what still needs to be done to protect children from death or injury in transportation-related crashes. The following issues areas are examined: air bags and children, permanent child safety seat fitting stations, child occupant protection laws, car designs that focus on children, school transportation for children, passenger vans used for school activities, zero alcohol tolerance for drivers under age 21, graduated driver licensing for new and novice drivers, recreational boating safety, and child restraints in aviation. KW - Air bags KW - Alcohol use KW - Aviation KW - Boating KW - Child restraint systems KW - Children KW - Driver licensing KW - Fatalities KW - Graduated licensing KW - Injuries KW - Laws and legislation KW - Motor vehicles KW - Occupant protection devices KW - Protection KW - School buses KW - School children KW - Schools KW - Traffic crash victims KW - Traffic crashes KW - Vans KW - Vehicle design KW - Zero tolerance UR - http://ntl.bts.gov/lib/18000/18100/18159/PB2001107153.pdf UR - http://ntl.bts.gov/lib/9000/9900/9999/SR0002.pdf UR - https://trid.trb.org/view/672489 ER - TY - RPRT AN - 00792205 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CONTROLLED FLIGHT INTO TERRAIN, KOREAN AIR FLIGHT 801, BOEING 747-300, HL7468, NIMITZ HILL, GUAM, AUGUST 6, 1997 PY - 2000 SP - 223 p. AB - This report explains the accident involving Korean Air flight 801, a Boeing 747-300, which crashed into high terrain at Nimitz Hill, Guam, on August 6, 1997. Safety issues in the report focus on flight crew performance, approach procedures, and pilot training; air traffic control, including controller performance and the inhibition of the minimum safe altitude warning system at Guam; emergency response; the adequacy of Korean Civil Aviation Bureau and Federal Aviation Administration oversight; and flight data recorder documentation. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration, the Governor of the Territory of Guam, and the Korean Civil Aviation Bureau. KW - Air traffic control KW - Air traffic controllers KW - Air transportation crashes KW - Airline pilots KW - Altitude KW - Approach KW - Aviation safety KW - Boeing 747 aircraft KW - Emergency response time KW - Fatalities KW - Flight crews KW - Flight recorders KW - Guam KW - Injuries KW - Korean Civil Aviation Bureau KW - Oversight KW - Performance KW - Recommendations KW - Safe altitude warning systems KW - Training KW - U.S. Federal Aviation Administration KW - Warning systems UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR0001.pdf UR - https://trid.trb.org/view/648785 ER - TY - RPRT AN - 01003090 AU - National Transportation Safety Board TI - Marine Accident Brief: Collision between Panamanian Container Ship Ever Grade and U.S. Coast Guard Buoy Tender Cowslip, Columbia River near Astoria, Oregon, May 14, 1997 PY - 1999/12/30 SP - 8p AB - About 2125 on May 14, 1997, the U.S. Coast Guard buoy tender Cowslip collided with the Panamanian container ship Ever Grade in the Columbia River near Astoria, Oregon. The weather was calm with visibility severely reduced by fog to about 200 yards. One crew member of the Cowslip was injured. Property damage was estimated at $1.2 million. The National Transportation Safety Board determines that the probable cause of the collision between the Ever Grade and the Cowslip was the failure of the pilot of the Ever Grade to gauge the turn at Tansy Point properly due to imprecise radar estimations of his vessel's position and late application of rudder, which combined to cause the ship to swing excessively wide in the turn and to strike the Cowslip. Contributing to the accident was the joint decision of the pilot of the Ever Grade and the commanding officer of the Cowslip to attempt a meeting at a sharp bend in the channel during a period of severely reduced visibility. The vice chairman of the NTSB Robert T. Francis II, filed an additional statement with his concurrence, stating that the probable cause statement does not go far enough in recognizing the importance of bridge resource management techniques and effective ship-to-ship communications in enhancing maritime safety. Breakdowns in communication on and between the vessels should have been noted as a contributing factor in the collision. KW - Channels (Waterways) KW - Columbia River KW - Communication KW - Containerships KW - Crash causes KW - Crash investigation KW - Crash reports KW - Maritime safety KW - Navigation radar KW - Oregon KW - Ship pilotage KW - Tenders KW - United States Coast Guard KW - Visibility distance KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB9901.pdf UR - https://trid.trb.org/view/759364 ER - TY - RPRT AN - 00798256 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-99-55 PY - 1999/11/02 SP - 2 p. AB - This safety recommendation addressed to Ms. Barbara Harsha, Executive Director, National Association of Governors' Highway Safety Representatives, recommends that the National Association of Governors' Highway Representatives, in conjunction with the Department of Transportation, amend the Model Minimum Uniform Crash Criteria's bus configuration coding to comply with standard definitions and classifications of buses. KW - Buses KW - Model Minimum Uniform Crash Criteria KW - National Association of Governors' Highway Safety Reps KW - Recommendations KW - Safety UR - http://www.ntsb.gov/safety/safety-recs/recletters/H99_55.pdf UR - https://trid.trb.org/view/655252 ER - TY - RPRT AN - 00798262 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFET RECOMMENDATIONS, H-99-45 THROUGH H-99-54 PY - 1999/11/02 SP - 10 p. AB - This safety recommendation, addressed to Ms. Rosalyn G. Millman, Acting Administrator, National Highway Traffic Safety Administration, recommends that the National Highway Traffic Safety Administration: (1) In 2 years, develop performance standards for school bus occupant protection systems that account for frontal, side, and rear impact collisions, and rollovers (H-99-45); (2) Once pertinent standards have been developed for school bus occupant protection systems, require newly manufactured school buses to have an occupant crash protection system that meets the newly developed performance standards and retains passengers, including those in child safety restraint systems, within the seating compartment throughout the accident sequence for all accident scenarios (H-99-46); (3) In 2 years, develop performance standards for motorcoach occupant protection systems that account for frontal, side, and rear impact collisions, and rollovers (H-99-47); (4) Once pertinent standards have been developed for motorcoach occupant protection systems, require newly manufactured motorcoaches to have an occupant crash protection system that meets the newly developed performance standards and retains passengers, including those in child safety restraint systems, within the seating compartment throughout the accident sequence for all accident scenarios (H-99-48); (5) Expand their research on current advanced glazing to include its applicability to motorcoach occupant ejection prevention, and revise window glazing requirements for newly manufactured motorcoaches based on the results of this research (H-99-49); (6) In 2 years, develop performance standards for motorcoach roof strength that provide maximum survival space for all seating positions and that take into account current typical motorcoach window dimensions (H-99-50); (7) Once performance standards have been developed for motor coach roof strength, require newly manufactured motorcoaches to meet those standards (H-99-51); (8) Modify their methodology to collect accurate, timely, and sufficient data on passenger injuries resulting from school bus accidents so that thorough assessments can be made relating to school bus safety (H-99-52); (9) Require that all school buses and motorcoaches manufactured after January 1, 2003, be equipped with on-board recording systems that record vehicle parameters. For those buses so equipped, the following should also be recorded: status of additional seat belts, airbag deployment criteria, airbag deployment time, and airbag deployment energy. The on-board recording system should record data at a sampling rate that is sufficient to define vehicle dynamics and should be capable of preserving data in the event of a vehicle crash or an electrical power loss. In addition, the on-board recording system should be mounted to the bus body, not the chassis (H-99-53); and (10) Develop and implement, in cooperation with other Government agencies and industry, standards for on-board recording of bus crash data (H-99-54). KW - Air bags KW - Bus crashes KW - Buses KW - Child restraint systems KW - Deployment KW - Frontal crashes KW - Glazing KW - Injuries KW - Occupant protection devices KW - Passenger compartments KW - Passengers KW - Performance KW - Rear end crashes KW - Recommendations KW - Recording instruments KW - Roofs KW - Safety KW - School buses KW - School safety KW - Seat belts KW - Side crashes KW - Standards KW - Strength of materials KW - Windows (Vehicles) UR - http://www.ntsb.gov/safety/safety-recs/recletters/H99_45_54.pdf UR - https://trid.trb.org/view/655261 ER - TY - RPRT AN - 00798257 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATION, H-99-56 PY - 1999/11/02 SP - 7 p. AB - This safety recommendation, addressed to the bus manufacturers, recommends that the bus manufacturers cooperate with the Department of Transportation in the development of standard definitions and classifications for each of the different bus body types (H-99-56). KW - Body type (buses) KW - Buses KW - Classification KW - Definitions KW - Industries KW - Recommendations KW - School buses KW - Standards KW - Transit buses UR - http://www.ntsb.gov/safety/safety-recs/recletters/H99_56.pdf UR - https://trid.trb.org/view/655253 ER - TY - RPRT AN - 00798258 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY RECOMMENDATIONS, H-99-43 AND H-99-44 PY - 1999/11/02 SP - 4 p. AB - This safety recommendation, addressed to the Honorable Rodney E. Slater, Secretary, U.S. Department of Transportation, recommends that the U.S. Department of Transportation: (1) In one year and in cooperation with the bus manufacturers, complete the development of standard definitions and classifications for each of the different bus body types, and include these definitions and classifications in the Federal Motor Vehicle Safety Standards (FMVSS) (H-99-43); and (2) Once the standard definitions and classifications for each of the different bus types have been established in the Federal Motor Vehicle Safety Standards, in cooperation with the National Association of Governors' Highway Safety Representatives, amend the Model Minimum Uniform Crash Criteria's bus configuration coding to incorporate the FMVSS definitions and standards (H-99-44). KW - Buses KW - Classification KW - Definitions KW - Federal Motor Vehicle Safety Standards KW - Industries KW - Model Minimum Uniform Crash Criteria KW - National Association of Governors' Highway Safety Reps KW - Recommendations KW - Safety KW - Standards KW - U.S. Department of Transportation UR - http://www.ntsb.gov/safety/safety-recs/recletters/H99_43_44.pdf UR - https://trid.trb.org/view/655254 ER - TY - RPRT AN - 00791485 AU - National Transportation Safety Board TI - MARINE ACCIDENT REPORT: SINKING OF THE RECREATIONAL SAILING VESSEL MORNING DEW AT THE ENTRANCE TO THE HARBOR OF CHARLESTON, SOUTH CAROLINA, DECEMBER 29, 1997 PY - 1999/10/05 SP - 92 p. AB - During the early morning hours of December 29, 1997, the 34-ft (10.4-m) recreational sailing vessel Morning Dew struck the rock jetty on the north side of the shipping channel into the harbor of Charleston, South Carolina. The owner/operator of the vessel and his three passengers, all members of the same family, died as a result of the accident. The major safety issues identified in this investigation are the adequacy of the reasoning and decision-making of the operator; the fatigue and hypothermia suffered by the operator; the adequacy of the reasoning and decision-making of U.S. Coast Guard Group Charleston's watchstanders; the adequacy of Coast Guard Group Charleston's personnel, equipment, and procedures for responding to an emergency; and the role of the Coast Guard in providing factual information for safety investigations. As a result of its investigation, the Safety Board makes safety recommendations to the U.S. Coast Guard, the Governors of the 50 States and the U.S. Territories, the National Association of State Boating Law Administrators, the U.S. Coast Guard Auxiliary, the U.S. Power Squadrons, the National Safe Boating Council, and the Boat Owners Association of the United States. KW - Crash investigation KW - Decision making KW - Disaster preparedness KW - Fatalities KW - Fatigue (Physiological condition) KW - Hypothermia KW - Maritime safety KW - Recommendations KW - Sailing ships KW - Ship operators KW - United States Coast Guard KW - United States Coast Guard Group Charleston KW - Watchstanders KW - Water transportation crashes UR - http://ntl.bts.gov/lib/22000/22300/22328/PB99916401.pdf UR - http://ntl.bts.gov/lib/22000/22300/22328/PB99916401.pdf UR - https://trid.trb.org/view/648498 ER - TY - RPRT AN - 01139249 AU - National Transportation Safety Board TI - Hazardous Materials Accident Report: Overflow of Gasoline and Fire at a Service Station-Convenience Store, Biloxi, Mississippi, August 9, 1998 PY - 1999/09/21 SP - 55p AB - This report explains the gasoline overflow and resulting fire that occurred during a cargo transfer by Premium Tank Lines, Inc., to an underground storage tank at a Fast Lane gasoline station-convenience store in Biloxi, Mississippi, on August 9, 1998. The fire engulfed three vehicles at a nearby intersection, which ultimately resulted in the deaths of five occupants and the serious injury of one. Damages were estimated at $55,000. From its investigation of this accident, the Safety Board identified safety issues in the following areas: Premium Tank Line, Inc.’s management oversight; R.R. Morrison and Son, Inc.’s procedures for accepting petroleum product deliveries to underground storage tanks; and Federal requirements and oversight. Based on its findings, the Safety Board made recommendations to the Federal Highway Administration, the Research and Special Programs Administration, the Environmental Protection Agency, Premium Tank Lines, Inc., R.R. Morrison and Son, Inc., the American Petroleum Institute, the National Tank Truck Carriers Association, the National Association of Convenience Stores, the National Association of Truck Stop Operators, the Petroleum Marketers Association of America, the Service Station Dealers of America, and the Society of Independent Gasoline Marketers of America. KW - Cargo transfer KW - Fatalities KW - Fires KW - Gasoline KW - Hazardous materials KW - Hazardous materials accidents KW - Storage tanks UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM9902.pdf UR - https://trid.trb.org/view/898598 ER - TY - RPRT AN - 00782296 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD PUBLIC MEETING OF SEPTEMBER 21,1999, ABSTRACT OF FINAL REPORT (SUBJECT TO EDITING) - HIGHWAY SPECIAL INVESTIGATION: BUS CRASHWORTHINESS PY - 1999/09/21 SP - 4 p. AB - This is an abstract from the National Transportation Safety Board's report and does not include the Board's rationale for the safety recommendations. The following information is subject to further review and editing. Although much has been done to improve the safety of school buses and motorcoaches over the years, the safe transportation of bus passengers, especially students and senior citizens, continues to be a national priority. To address crucial issues on bus safety, this special investigation examines school bus and motorcoach crashworthiness issues through the analysis of 6 school bus and 40 motorcoach accidents, and through information gathered at the Safety Board's August 12, 1998, public hearing. The Board's report also evaluates the Federal Motor Vehicle Safety Standards (FMVSS) that govern the design of school buses and motorcoaches to determine the effectiveness of these standards and to determine whether further occupant protection measures are needed. Also included here are the results of computer simulations performed to evaluate the safety levels afforded by passenger crash protection systems not currently required for school buses. Further, the report reviews international perspectives on, and developments in, motorcoach occupant protection. Finally, the report addresses data collection issues that are hampering effective accident study. During the Safety Board's discussion of bus crashworthiness issues, this special investigation identifies the following safety issues: effectiveness of current school bus occupant protection systems; effectiveness of Federal motorcoach bus crashworthiness standards and occupant protection systems; discrepancies between different Federal bus definitions; deficiencies in the National Highway Traffic Safety Administration's Fatality Analysis Reporting Systems bus ejection data; and lack of school bus injury data. KW - Aged KW - Buses KW - Computer models KW - Crashworthiness KW - Data collection KW - Design KW - Ejection KW - Fatality Analysis Reporting System KW - Injuries KW - International KW - Occupant protection devices KW - Passengers KW - School buses KW - School children KW - Simulation KW - Standards KW - Traffic safety KW - Vehicle safety UR - https://trid.trb.org/view/636180 ER - TY - RPRT AN - 00816383 AU - National Transportation Safety Board TI - HAZARDOUS MATERIALS ACCIDENT REPORT: FIRE AND EXPLOSION OF HIGHWAY CARGO TANKS, STOCK ISLAND, KEY WEST, FLORIDA, JUNE 29, 1998 PY - 1999/09/10 SP - 36 p. AB - About 5:14 a.m., eastern daylight time, on June 29, 1998, at Stock Island, Key West, Florida, a Dion Oil Company driver was on top of a straight-truck cargo tank checking the contents of its compartments and preparing to transfer cargo from a semitrailer cargo tank when explosive vapors ignited within the straight-truck cargo tank. The ignition caused an explosion that threw the driver from the top of the truck. The fire and a series of at least three explosions injured the driver and destroyed the straight truck, a tractor, the front of the semitrailer, and a second nearby straight-truck cargo tank. Damage was estimated at more than $185,000. The safety issues discussed in this report are the adequacy of Dion Oil Company's product-transfer procedures and training, the adequacy of the Federal Highway Administration's oversight of motor carriers' procedures and training for loading and unloading hazardous materials, and the adequacy of Florida's oversight of the fire safety of storage tanks. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Federal Highway Administration, Dion Oil Company, the Florida State Fire Marshal, the Florida Department of Transportation, the Florida Department of Agriculture, the Florida Department of Environmental Protection, the National Fire Prevention Association, the National Association of State Fire Marshals, and the International Association of Fire Chiefs. KW - Crash investigation KW - Explosions KW - Fire KW - Hazardous materials KW - Liquid cargo handling KW - Oil tankers KW - Oversight KW - Procedures KW - Product transfer KW - Recommendations KW - Stock Island (Key West, Florida) KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM9901.pdf UR - https://trid.trb.org/view/690694 ER - TY - RPRT AN - 00784323 AU - National Transportation Safety Board TI - BUS CRASHWORTHINESS ISSUES. HIGHWAY SPECIAL INVESTIGATION REPORT PY - 1999/09 SP - 143 p. AB - School bus and motorcoach travel are two of the safest forms of transportation in the United States. Each year, on average, nine school bus passengers and four motorcoach passengers are fatally injured in bus crashes, according to the National Highway Traffic Safety Administration (NHTSA) and motorcoach industry statistics. In comparison, NHTSA statistics show that in 1998 over 41,000 people were fatally injured in highway crashes. Although much has been done to improve the safety of school buses and motorcoaches over the years, the safe transportation of bus passengers, especially students and senior citizens, continues to be a national safety priority. Children and seniors are predicted to be the fastest growing segments of our society, and these groups are the primary users of bus transportation. This special investigation was initiated to determine whether additional measures should be taken to better protect bus occupants. It examines school bus and motorcoach crashworthiness issues through the analysis of 6 school bus and 40 bus accidents. KW - Bus crashes KW - Crashworthiness KW - Fatalities KW - Occupant protection devices KW - School buses KW - Transit buses UR - http://app.ntsb.gov/doclib/reports/1999/SIR9904.pdf UR - http://ntl.bts.gov/lib/8000/8400/8408/SIR9904.pdf UR - https://trid.trb.org/view/636883 ER - TY - RPRT AN - 00783621 AU - National Transportation Safety Board TI - HIGHWAY SPECIAL INVESTIGATION REPORT: PUPIL TRANSPORTATION IN VEHICLES NOT MEETING FEDERAL SCHOOL BUS STANDARDS PY - 1999/06/08 SP - 75 p. AB - This report contains the findings of a special investigation conducted as a result of four fatal accidents involving nonconforming buses used to transport school children. In the first accident, on March 25, 1998, three children were ejected when the passenger van transporting them collided with a transit bus in Sweetwater, Florida. On March 26, 1998, two people were fatally injured when the specialty bus transporting the students collided with a truck tractor semitrailer in Lenoir City, Tennessee. On December 8, 1998, one child was ejected and fatally injured when the passenger van transporting the children collided with a pickup truck in East Dublin, Georgia. On February 16, 1999, in Bennettsville, South Carolina, three children were ejected and six children were fatally injured when the passenger van transporting them was struck by a tow truck. From its investigation, the Safety Board identified safety issues in the following areas: the adequacy of occupant crash protection and crashworthiness of nonconforming buses used to transport school children, the adequacy of State regulations and guidelines governing nonconforming buses used to transport school children, and the adequacy of State laws governing the use of restraint systems in nonconforming buses transporting school children. KW - Crashworthiness KW - Fatalities KW - Injuries KW - Laws KW - Nonconforming buses KW - Occupant protection devices KW - Passenger vehicles KW - Pickup trucks KW - Regulations KW - Restraint systems KW - School children KW - Standards KW - States KW - Students KW - Tractor trailer combinations KW - Traffic crash victims KW - Traffic crashes KW - Traffic safety KW - Vans KW - Vehicle occupants UR - http://app.ntsb.gov/doclib/reports/1999/SIR9902.pdf UR - http://ntl.bts.gov/lib/8000/8400/8409/SIR9902.pdf UR - https://trid.trb.org/view/636791 ER - TY - RPRT AN - 01393170 AU - National Transportation Safety Board TI - Evaluation of US Department of Transportation efforts in the 1990s to address operator fatigue PY - 1999/05 IS - NTSB/SR-99/01 SP - 104p KW - Accident countermeasure KW - Air transport KW - Air transportation KW - Fatigue (Physiological condition) KW - Highway transportation KW - Hours of labor KW - Hours of work KW - Human fatigue KW - Policy KW - Policy KW - Policy, legislation and regulation KW - Rail transport KW - Railroad transportation KW - Road transport KW - Safety KW - Safety KW - Sea transport KW - Traffic safety KW - Transport regulation KW - Water transportation UR - https://trid.trb.org/view/1160937 ER - TY - RPRT AN - 01013288 AU - National Transportation Safety Board TI - Safety Report: Evaluation of U.S. Department of Transportation Efforts in the 1990s to Address Operator Fatigue PY - 1999/05 SP - 113p AB - During the 1980s, the National Transportation Safety Board investigated several aviation, highway, and marine accidents that involved operator fatigue. Following completion of these investigations, the Safety Board in 1989 issued three recommendations to the U.S. Department of Transportation (DOT) addressing needed research, education, and revisions to hours-of-service regulations. In the 10 years that have passed, the Safety Board has issued more than 70 additional recommendations to the DOT, States, industry, and industry associations to reduce the incidence of fatigue-related accidents. In response to the three 1989 recommendations, the DOT and the modal administrations have, in general, acted and responded positively to those addressing research and education; little action, however, has occurred with respect to revising the hours-of-service regulations. Nevertheless, the Safety Board believes that support has grown in recent years to make substantive changes to these regulations. This report provides an update on the activities and efforts by the DOT and the modal administrations to address operator fatigue and, consequently, the progress that has been made in the past 10 years to implement the actions called for in the three intermodal recommendations and other fatigue-related recommendations. The report also provides some background information on current hours-of-service regulations, fatigue, and the effects of fatigue on transportation safety. As a result of this safety report, the National Transportation Safety Board issued new safety recommendations to the U.S. Department of Transportation, the Federal Aviation Administration, the Federal Highway Administration, the Federal Railroad Administration, the Research and Special Programs Administration, and the United States Coast Guard. The Safety Board also reiterated two recommendations to the Federal Aviation Administration. KW - Air pilots KW - Air transportation crashes KW - Fatigue (Physiological condition) KW - Hours of labor KW - Human factors in crashes KW - Intermodal transportation KW - Operators (Persons) KW - Railroad crashes KW - Railroads KW - Recommendations KW - Regulations KW - Traffic crashes KW - Transportation safety KW - Truck drivers KW - U.S. Department of Transportation KW - Water transportation KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/1999/SR9901.pdf UR - http://ntl.bts.gov/lib/14000/14200/14237/ADA372555.pdf UR - https://trid.trb.org/view/767328 ER - TY - RPRT AN - 00782279 AU - National Transportation Safety Board TI - EVALUATION OF TRANSPORTATION EFFORTS IN THE 1990S TO ADDRESS OPERATOR FATIGUE PY - 1999/05 SP - 109 p. AB - During the 1980s, the National Transportation Safety Board investigated several aviation, highway, and marine accidents that involved operator fatigue. Following completion of these investigations, the Safety Board in 1989 issued three recommendations to the U.S. Department of Transportation (DOT) addressing needed research, education, and revisions to hours-of-service regulations. In the 10 years that have passed, the Safety Board has issued more than 70 additional recommendations to the DOT, States, industry, and industry associations to reduce the incidence of fatigue-related accidents. In response to the three 1989 recommendations, the DOT and the modal administrations have, in general, acted and responded positively to those addressing research and education; little action, however, has occurred with respect to revising the hours-of-service regulations. Nevertheless, the Safety Board believes that support has grown in recent years to make substantive changes to these regulations. This report provides an update on the activities and efforts by the DOT and the modal administrations to address operator fatigue and, consequently, the progress that has been made in the past 10 years to implement the actions called for in the three intermodal recommendations and other fatigue-related recommendations. The report also provides some background information on current hours-of-service regulations, fatigue, and the effects of fatigue on transportation safety. As a result of this safety report, the National Transportation Safety Board issued new safety recommendations to the U.S. Department of Transportation, the Federal Aviation Administration, the Federal Highway Administration, the Federal Railroad Administration, the Research and Special Programs Administration, and the United States Coast Guard. The Safety Board also reiterated two recommendations to the Federal Aviation Administration. KW - Air transportation crashes KW - Fatigue (Physiological condition) KW - Hours of labor KW - Operators (Persons) KW - Railroad crashes KW - Recommendations KW - Regulations KW - Traffic crashes KW - Transportation safety KW - U.S. Department of Transportation KW - Water transportation crashes UR - http://app.ntsb.gov/doclib/reports/1999/SR9901.pdf UR - http://ntl.bts.gov/lib/14000/14200/14237/ADA372555.pdf UR - https://trid.trb.org/view/636164 ER - TY - RPRT AN - 00782280 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED DESCENT AND COLLISION WITH TERRAIN - USAIR FLIGHT 427 BOEING 737-300, N513AU, NEAR ALIQUIPPA, PENNSYLVANIA, SEPTEMBER 8, 1994 PY - 1999/03/24 SP - 366 p. AB - This report explains the accident involving USAir flight 427, a Boeing 737-300, which entered an uncontrolled descent and impacted terrain near Aliquippa, Pennsylvania, on September 8, 1994. Safety issues in the report focused on Boeing 737 rudder malfunctions, including rudder reversals; the adequacy of the 737 rudder system design; unusual attitude training for air carrier pilots; and flight data recorder parameters. Safety recommendations concerning these issues were addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Airline pilots KW - Attitude (Flight dynamics) KW - Attitudes KW - Aviation safety KW - Crashes KW - Data recorders KW - Design KW - Flight KW - Rudders KW - Terrain KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR9901.pdf UR - https://trid.trb.org/view/636165 ER - TY - RPRT AN - 00764858 AU - National Transportation Safety Board TI - HIGHWAY SPECIAL INVESTIGATION REPORT: SELECTIVE MOTORCOACH ISSUES PY - 1999/02/11 SP - 62 p. AB - This report contains the findings of a special investigation conducted as a result of two fatal motorcoach accidents. In the first accident, on October 14, 1995, two passengers sustained fatal injuries, 13 sustained serious injuries, and 26 received minor injuries when a 1989 Eagle motorcoach operated by Hammond Yellow Coach Line, Inc., overturned upon entering an Interstate 70 exit ramp in Indianapolis, Indiana. In the second accident, on July 29, 1997, one passenger sustained fatal injuries, the driver and 3 passengers sustained serious injuries, and 28 passengers sustained minor injuries when a 1985 Transportation Manufacturing Corporation (TMC) motorcoach operated by Rite-Way Transportation, Inc., drifted off the side of Interstate 95 near Stony Creek, Virginia, and down an embankment into the Nottoway River, where it came to rest on its left side, partially submerged in water. From its investigation, the Safety Board identified safety issues in the following areas: busdriver fatigue, Office of Motor Carriers safety rating methodology, emergency egress, and passenger safety briefings. KW - Bus crashes KW - Bus drivers KW - Emergency exits KW - Fatalities KW - Fatigue (Physiological condition) KW - Highway safety KW - Indiana KW - Injuries KW - Motor carriers KW - Passengers KW - Traffic safety KW - Virginia UR - http://app.ntsb.gov/doclib/reports/1999/SIR9901.pdf UR - http://ntl.bts.gov/lib/8000/8400/8410/SIR9901.pdf UR - https://trid.trb.org/view/501912 ER - TY - CONF AN - 01088116 AU - Westhoff, M A AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Using Operating Data at Natural Gas Pipelines PY - 1999 SP - pp 357-365 AB - Interstate natural gas pipelines are operated using sophisticated supervisory control and data acquisition (SCADA) systems. These systems are used to monitor, control and analyze operations. Software which runs in conjunction with the basic SCADA system expands the usefulness of SCADA data to enhance reliability and efficiency of operations, improve customer service, and minimize undesirable business practices, all in near real-time. Data from such systems are used off-line for the development of planning tools, training and system design studies. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Data collection KW - Natural gas pipelines KW - Operations KW - Planning KW - Software KW - Supervisory control and data acquisition KW - Utilization UR - http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.196.9685&rep=rep1&type=pdf UR - https://trid.trb.org/view/844155 ER - TY - CONF AN - 01088115 AU - Thompson, Michael H AU - National Transportation Safety Board AU - International Transportation Safety Association TI - A Vision of Future Crash Survivable Recording Systems PY - 1999 SP - pp 337-349 AB - For more than 40 years recording of flight data has developed from scratches made by stylus on aluminum foil, recording a handful of parameters, to silicon memory chips recording thousands of digital bits. There can be no doubt to the value obtained from airborne crash survivable recorders, however the perpetual enhancements in aircraft systems leads to the need for more data to be recorded as aircraft operation and performance become ever more sophisticated. This creates a moving target for the crash investigation community and recorder manufacturers to contend with. Today many aircraft incorporate centralized processing to automatically present information tailored to flight and operational conditions, and much of this data consists of the parameters processed for airborne recording. As changes emerge to the traditional partitioning of avionics by functionality to a design based on partitioning by flight criticality or operational applications, centralized processing increasingly impacts current systems/subsystems, customers and regulatory agencies. Gains in onboard computational power make more sophisticated onboard diagnostic and prognostic software a reality, but the emphasis tends to be on the ease of use, cost effectiveness, flexibility and integration and little thought to the airborne recording. As new technologies are introduced, it should be as a means to enhance safer air travel and utilize the effect of computational power to provide system flexibility and growth, while maintaining a minimal impact on recording systems and aircraft integration. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air transportation crashes KW - Aircraft KW - Aviation safety KW - Crash data KW - Crash investigation KW - Flight recorders KW - Future KW - Survivability KW - Technological innovations UR - http://www.aerohabitat.eu/uploads/media/10-12-2008_-_M_H_Thompson_-_A_vision_of_future_crash_survivable_01.pdf UR - https://trid.trb.org/view/844151 ER - TY - CONF AN - 01088114 AU - Thomas, Neill L AU - Freund, Deborah M AU - National Transportation Safety Board AU - International Transportation Safety Association TI - On-Board Recording for Commercial Motor Vehicles and Drivers: Microscopic and Macroscopic Approaches PY - 1999 SP - pp 325-335 AB - Approximately 2.3 million drivers operate commercial motor vehicles (CMVs) in interstate commerce. Crashes involving these vehicles are important safety concerns of the Federal Highway Administration (FHWA) for several reasons (FHWA, 1999): 1. On average, CMVs travel 5-10 times the annual miles of passenger cars. Although the crash rate of CMVs has held steady for several years, the number of crashes has risen because the number of vehicles and distance traveled both are increasing. 2. Heavy trucks make up 3% of the registered vehicle population in the United states, account for 7% of all vehicle miles traveled, but represent 9% of motor vehicles involved in fatal crashes. 3. CMV-related fatal crashes and injuries cost the U.S. economy $15 billion annually. 4. Non-CMV vehicles and their drivers bear most of costs of CMV-related crashes: 85% of fatalities, 75% of injuries, 67% of economic losses. Hours-of-service of CMV drivers are covered under the Federal Motor Carrier Safety Regulations (FMCSRs), at Title 49, Part 395, of the Code of Federal Regulations. The regulations prohibit a driver from driving more than 10 hours following a minimum of 8 consecutive hours off-duty, or driving after 15 hours on-duty [including any driving time] following a minimum of 8 consecutive hours off-duty. They require a driver to be given at least 8 consecutive hours off duty between driving and on-duty periods. Drivers are also prohibited from operating a CMV after accumulating 60 hours on-duty in any 7 consecutive day period (if the motor carrier does not operate its vehicles every day of the week), or 70 hours in any 8 consecutive days (if the motor carrier operates CMVs every day of the week). The requirement for CMV drivers to record their hours-of-service, and for motor carriers to maintain those records is included in regulations written in 1939 and still in effect. The record of duty status (RODS), commonly known as a driver’s log, must be completed by all CMV drivers operating in interstate commerce. Details of the requirement are contained in 49 CFR 395.8. Because compliance with hours-of-service regulations (i.e., not exceeding maximum driving and duty time limits, and being afforded at least the minimum off-duty time for purposes of obtaining rest) has a strong influence on the ability of a driver to perform safely, the recording of duty status and time becomes an essential regulatory issue. The authors believe there are merits to both macroscopic (vehicle and operationally-oriented) and microscopic (driver self-monitoring) approaches for planning and monitoring duty and non-duty times to enhance safe and productive CMV transportation. Two FHWA projects -- a research study and an operational test -- are exploring the feasibility of these different, yet complementary, approaches. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Commercial vehicle operations KW - Commercial vehicles KW - Crash causes KW - Economic impacts KW - Fatalities KW - Federal Motor Carrier Safety Regulations KW - Heavy duty trucks KW - Highway safety KW - Hours of labor KW - Injuries KW - Logging (Recording) KW - Macroscopic models KW - Microscopic models KW - Monitoring KW - Planning KW - Traffic crashes KW - Traffic safety KW - Truck crashes KW - Truck drivers KW - Trucking safety KW - United States UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844149 ER - TY - CONF AN - 01088113 AU - Stevens, Thomas AU - Onley, Robert E AU - Morich, Robert S AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Design of a Crash Survivable Locomotive Event Recorder PY - 1999 SP - pp 313-323 AB - The FRA is presently preparing a regulation covering the crash survivability of the Locomotive Event Recorder. This regulation will also specify the minimum number of parameters to be recorded and how this requirement will be phased-in on existing and new locomotives. The parameter selection reflects the more advanced control systems now in use or planned for use in the modern passenger or freight locomotive. In lieu of periodic inspection and test, the regulation will require the Event Recorder to incorporate internal self-monitoring. Self-monitoring will extend the inspection interval to one year and, based on good one-year results, extend the interval to three years. The crash survivability test levels and test methods are based on the European Organization for Civil Aviation Equipment (EUROCAE) documents, ED-55, “Minimum Operation Specification for Flight Data Recorder System,” and ED-56A, “Minimum Operation Requirement for Cockpit Voice Recorder System.” The tests, test levels and methods have been modified to reflect the lower speeds and heavier structure of the locomotives. The product of the crash survivability is the recorded data. Specifics covering the recovery of the data are not intended to be incorporated into the regulation. However, the rail system, like the airborne flight data recorders, must have provisions to recover the data down to the memory board and memory chip level. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Crash data KW - Equipment KW - Event recorders KW - Locomotives KW - Rail recorders KW - Railroad crashes KW - Railroad safety KW - Survivability UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844147 ER - TY - CONF AN - 01088112 AU - Smith, Ian AU - Posluns, Howard AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Standardized Flight Recorder Documentation PY - 1999 SP - pp 307-311 AB - The need for an international standard to document the format and arrangement of flight data recorded by Flight Data Recorder Systems (FDRS) has long been recognized by air safety investigators responsible for the retrieval and analysis of FDR data following an occurrence. Significant time delays can be eliminated where complete and accurate information about the Flight Data Recorder System is readily available to investigative authorities. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Accuracy KW - Air transportation crashes KW - Aviation safety KW - Crash investigation KW - Data completeness KW - Data quality KW - Flight recorders KW - International KW - Standards UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844146 ER - TY - CONF AN - 01088111 AU - Schofield, Duncan W AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Feasibility of Battery Backup for Flight Recorders PY - 1999 SP - pp 301-306 AB - On March 9, 1999, the National Transportation Safety issued Recommendations A-99-16 and A-99-17 calling for revisions to the FAA Regulations dealing with Cockpit Voice Recorders and their installation in commercial aircraft. These recommendations read as follows. (1) Require retrofit after January 1, 2005, of all cockpit voice recorders (CVRs) on all airplanes required to carry both a CVR and a flight data recorder (FDR) with a CVR that (a) meets Technical Standard Order (TSO) C123a, (b) is capable of recording the last 2 hours of audio, and (c) is fitted with an independent power source that is located with the digital CVR and that automatically engages and provides 10 minutes of operation whenever aircraft power to the recorder ceases, either by normal shutdown or by a loss of power to the bus (A-99-16). (2) Require all aircraft manufactured after January 1, 2003, that must carry both a cockpit voice recorder (CVR) and a digital flight data recorder (DFDR) to be equipped with two combination (CVR/DFDR) recording systems. One system should be located as close to the cockpit as practicable and the other as far aft as practicable. Both recording systems should be capable of recording all mandatory data parameters covering the previous 25 hours of operation and all cockpit audio including controller–pilot data link messages for the previous 2 hours of operation. The system located near the cockpit should be provided with an independent power source that is located with the combination recorder, and that automatically engages and provides 10 minutes of operation whenever normal aircraft power ceases, either by normal shutdown or by a loss of power to the bus. The aft system should be powered by the bus that provides the maximum reliability for operation without jeopardizing service to essential or emergency loads, whereas the system near the cockpit should be powered by the bus that provides the second highest reliability for operation without jeopardizing service to essential or emergency loads (A-99-17). A key element of these recommendations is the requirement to provide an independent power source which provides 10 minutes of continued operation following the removal of the main aircraft power. This paper will discuss the feasibility of an independent power source for the Flight Data Recorder and the Cockpit Voice Recorder. And in addition, offer two options for complying with the recommended requirement and offer some comparative analysis of the two options. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Aviation safety KW - Civil aircraft KW - Cockpit voice recorders KW - Electric batteries KW - Electric power supply KW - Emergency power supply KW - Feasibility analysis KW - Flight recorders UR - http://www.iasa.com.au/folders/Publications/pdf_library/schofield.pdf UR - https://trid.trb.org/view/844141 ER - TY - CONF AN - 01088110 AU - Scaman, R Jeffrey AU - National Transportation Safety Board AU - International Transportation Safety Association TI - The Benefits of Vehicle-Mounted Video Recording Systems PY - 1999 SP - pp 295-300 AB - This document will explore the topic of Vehicle-Mounted Video Recording Systems and the potential benefits they will provide to the Transportation, Law Enforcement and Insurance Industries. Currently, there is technology available that will permit the development and deployment of Vehicle-Mounted Video Recording Systems, however this technology is not being effectively utilized. It is the belief of the author, that the introduction of such recording systems would offer numerous benefits to all entities concerned with transportation safety and efficiency. The current methods of accident investigation and reconstruction being used by the Transportation Industry are inefficient and outdated, based on today's technology. This paper will examine current methods of transportation recording and accident investigation, while pointing out the potential benefits of Vehicle-Mounted Video Recording Systems. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Benefits KW - Crash data KW - Crash investigation KW - Crash reconstruction KW - Event data recorders KW - Highway safety KW - Insurance industry KW - Law enforcement KW - Traffic safety KW - Vehicle body parts KW - Video technology UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844135 ER - TY - CONF AN - 01088109 AU - Ripley, Todd AU - King, Thomas AU - Chen, Henry AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Improving Ship Safety and Efficiency with Proactive Use of Voyage Data Recorders PY - 1999 SP - pp 289-294 AB - The use of Shipborne Voyage Data Recorder (VDR) in the commercial maritime industry can raise both safety and operation efficiency levels. Although it is late coming compared with aviation industries, the International Maritime Organization (IMO) has recently passed the resolution A.861(20) Performance Standards for Shipborne Voyage Data Recorders. The International Electrotechnical Commission (IEC) is currently finalizing the technical specification of the VDR for type approval. Carriage requirements are now under discussion at IMO and will become a reality in the near future. While mandatory carriage requirement is still years away, some progressive shipping companies have already started to install VDR as part of an advanced Integrated Bridge System (IBS). Actual field experience shows that cost-effective VDRs can be built and maintained to meet reasonable performance requirements with today's technology. Although the primary purpose of the VDR is for accident investigation after the fact, innovative uses of the VDR by the operators both in real-time and post voyage modes have demonstrated VDRs can improve safety as well as efficiency of operations. The concept is similar to the use of flight recorder to store engine data for maintenance in the aircraft industry. This paper describes several areas of proactive use of VDRs for central alarm management, performance efficiency monitoring, heavy weather damage avoidance and seamanship skill training. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Alarm systems KW - Crash investigation KW - Efficiency KW - Maritime safety KW - Merchant seamen KW - Monitoring KW - Performance KW - Ship damage KW - Training KW - Utilization KW - Voyage data recorders KW - Weather UR - http://citeseerx.ist.psu.edu/viewdoc/download;jsessionid=535AA1D66A1696C2F591461E033FEFA1?doi=10.1.1.126.902&rep=rep1&type=pdf UR - https://trid.trb.org/view/844131 ER - TY - CONF AN - 01088108 AU - Plantin de Hughes, Philippe AU - Perry, Thomas AU - National Transportation Safety Board AU - International Transportation Safety Association TI - EUROCAE WG-50 Activity: Aircraft On Board Video Recording PY - 1999 SP - pp 285-288 AB - The subject of the presentation is to introduce the work done by the Working Group 50 of EUROCAE regarding flight recorders performance specifications and mainly the on-board video recording. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Aircraft KW - Digital video KW - Flight recorders KW - On board equipment KW - Performance KW - Specifications UR - http://www.iasa.com.au/folders/Publications/pdf_library/plantindehugues.pdf UR - https://trid.trb.org/view/844129 ER - TY - CONF AN - 01088107 AU - Mackey, John J AU - Brogan, Christopher J AU - Bates, Edward AU - Ingalls, Stephen AU - Howlett, Jack AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Digital Eye-Witness Systems PY - 1999 SP - pp 271-283 AB - According to the National Center for Health Statistics, “National Health Survey”, in 1996 there were 35 million motor vehicle accidents with an associated total economic loss of $120.8b. Approximately 60% of the $120.8b was spent on claims payment and an additional 12% in legal fees. What is not known is how much of this amount was spent settling or defending fraudulent and frivolous claims. However, Loss Management Services, Inc. (LMS) does have a way to control these costs. LMS has developed systems to control claims pay out and litigation costs while deterring fraudulent and frivolous claims, along with providing for a real crash data bank for regulatory agencies. LMS has developed the MAC (Mobile Accident Camera) Box system which will record the events leading up to an accident, capture accident data and record the aftermath. The MACbox will provide a “driver’s eye view” of the entire incident from beginning to end. The only difference is that the MACbox will disclose without bias, the event as it occurred. The system is an application of existing commercial technology answering the most common and most vexing mystery: Whose fault was it? And, what happened? By working closely with its client companies, the insurance industry and its technology partners LMS will also establish a rich repository of information that will be used to help mediate claims, assign responsibility, advance vehicle safety and reduce the total economic loss that results from motor vehicle accidents. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Cameras KW - Cost control KW - Crash data KW - Crash reconstruction KW - Fraud KW - Insurance claims KW - Litigation KW - Traffic crashes KW - Traffic safety UR - http://www.iasa.com.au/folders/Publications/pdf_library/mackey.pdf UR - https://trid.trb.org/view/844125 ER - TY - CONF AN - 01088106 AU - Levine, Sy AU - National Transportation Safety Board AU - International Transportation Safety Association TI - The Remote Aircraft Flight Recorder and Advisory Telemetry System, RAFT (Patented), And It’s Ability to Reduce Fatal Air Accidents By 78% While Enhancing Air Space Capacity, Operational Efficiency and Aircraft Security PY - 1999 SP - pp 247-270 AB - RAFT is a worldwide, real-time aircraft remote monitoring and recording system that takes an aircraft’s Digital Flight Data Recorder, DFDR, monitoring parameters out of an archival data base and plugs them into a safe, readily available, usable accident prevention system. RAFT combines the DFDR sensor data with the data from the Air Traffic Management/Control (ATM/C) system along with GPS/GLONASS, Map, Terrain and Weather information to actively anticipate and prevent accidents. It ends the information vacuum created by the aircraft and the ATM/C where presently each of them, acting independently, don’t have sensors that directly measure the necessary parameters required to prevent a crash. By the sharing of the digital data, all of the necessary crash prevention parameters become visible and usable to actively anticipate and prevent problems from turning into fatal accidents. It opens the whole field of commercial aviation to the use of expert systems to minimize fatal accidents. Privileged non-safety related data is ciphered at the aircraft to insure air carrier confidentiality. In addition, the global telemetry of the DFDR parameters allows aircraft monitored data to be simply and safely stored on the ground; thus making it readily available for aircraft statistical analysis programs that enhance air carrier efficiency and safety. Also, in the advent of a crash, it provides a timely accurate global estimate of the downed aircraft’s location for search, recovery and hopefully rescue operations. It establishes an aircraft global data super highway that uses high bandwidth satellite and ground Internet communication links to supply the aircraft advisories necessary to enhance air space capacity, operational efficiency, security and reduce fatal accidents by seventy-eight percent. RAFT brings to aviation what the Internet brought to data visibility and utilization. It unifies the National Airspace System (NAS) and fills the information vacuum that has been responsible for twenty years of a stagnant air carrier fatal accident rate. This information vacuum has seriously compromised the safety net and is the major cause of the stagnant air carrier fatal accident rate. It has also led to a situation where currently air travel is over nine times more lethal than bus travel, over three times more lethal than car travel and over fifteen times more lethal than space shuttle travel. RAFT makes all of the necessary safety data visible and readily available to the people who need to solve problems. It does this in a timely and cost effective manner, before they become fatal accidents. This is accomplished by reducing workloads while unambiguously enhancing the situation awareness. The present overly dependent verbal system, that is prone to fatal misinterpretations, is supplemented with visual safety emergency icons and physical synthetic vision representations of the situation. RAFT also provides functional redundancy, simplifies the communication system and enhances the safety and timely availability of the recorded data. It is the only system capable of meeting the national goal of reducing the fatal accident rate by a factor of five in ten years and provides the necessary safety net that should be put in place prior to any transition to free flight. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Access KW - Air traffic control KW - Air transportation crashes KW - Aircraft KW - Aircraft operations KW - Airlines KW - Airspace capacity KW - Aviation safety KW - Countermeasures KW - Crash data KW - Data sharing KW - Digital data KW - Expert systems KW - Fatalities KW - Flight recorders KW - Global Positioning System KW - Icons KW - Mapping KW - Monitoring KW - National Airspace System KW - Redundancy KW - Remote sensing KW - Safety equipment KW - Security KW - Telemetry KW - Terrain KW - Weather UR - http://www.iasa.com.au/folders/Publications/pdf_library/levine.pdf UR - https://trid.trb.org/view/844123 ER - TY - CONF AN - 01088105 AU - Lechowicz, Stephen AU - Hunt, Chris AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Monitoring and Managing Wheel Condition and Loading PY - 1999 SP - pp 205-239 AB - Damaged wheels, hot bearings and bad loading practices are increasingly recognized as major contributors to the hazards and costs of the rail industry. To improve both safety and economy, rail operators need vehicle condition data. A combination of wheel, bearing and load monitoring integrated by an effective database application can present the necessary information in a way that can be used productively. Teknis has developed a system that provides accurate in-motion weighing and comprehensive analysis of load distribution plus defect detection and classification at wheel, bogie, wagon and train levels. Teknis' Wheel Impact Load Detector (WILD) is designed to allow track and structure owners to monitor the vehicles running on their rails and rolling stock owners to optimize their maintenance scheduling. The system is low-cost, quick to install and maintain and requires no modification to the track. This paper presents an overview of the technology and operational results reported by National Rail. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Bearings KW - Car trucks (Railroads) KW - Car wheels (Railroads) KW - Condition data KW - Defects KW - Detection and identification KW - Freight cars KW - Load transfer KW - Maintenance KW - Monitoring KW - Operations KW - Railroad cars KW - Railroad trains KW - Technology KW - Wheel loads UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844121 ER - TY - CONF AN - 01088104 AU - Lang, J S AU - Beer, N A AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Voyage Data Recorders in Marine Accident Investigations PY - 1999 SP - pp 199-204 AB - Data recorders are now commonplace in many forms of transport and have made a substantial contribution to the understanding of accident causes and the improvement of safety. Recorded data has enabled accident investigators to reconstruct events to identify precisely what went wrong and to ensure that effective, rather than convenient, recommendations can be made to prevent the same thing happening again. While many transport modes recognize the value of such devices, sections of the marine community have yet to be convinced. This reluctance to accept the value of data recorders and take positive measures to fit them in merchant vessels is, in the opinion of the authors of this paper, a contributory factor to the poor safety record of some ship owners today. This paper not only argues the case for Voyage Data Recorders (VDRs) but gives examples of rudimentary data recordings that have made significant differences to the quality of United Kingdom marine accident investigations. There is no doubt that they have not only led to a much greater understanding of what actually occurred in each case but have done much to, arguably, ensure that the correct lessons are being learned. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Countermeasures KW - Crash data KW - Crash investigation KW - Crash reconstruction KW - Maritime safety KW - Voyage data recorders KW - Water transportation crashes UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844120 ER - TY - CONF AN - 01088103 AU - Kowalick, Thomas Michael AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Proactive Use of Highway Recorded Data via an Event Data Recorder (EDR) to Achieve Nationwide Seat Belt Usage in the 90th Percentile by 2002 PY - 1999 SP - pp 173-198 AB - Automobiles have been in existence for over a hundred years (1898-1999). Today, we have over two hundred and fourteen million in America alone, and six hundred and ninety million worldwide. Nationwide, forty-seven million vehicles are continually in-motion during daytime usage. Within twenty years these numbers are expected to double. Last year, twenty-four million vehicles were involved in a crash or accident. Over 40,000 people died (115 daily) and the total economic cost is estimated at $150 billion annually. (Blincoe 1996) The personal, social, and economic costs of motor vehicle crashes include pain and suffering; direct costs sustained by the injured persons and their insurers; indirect costs to taxpayers for health care and public assistance; and for many victims, a lower standard of living and quality of life. During the past two decades, motor vehicles accounted for over 90 percent of all transportation fatalities, and an even larger percentage of accidents and injuries. Our increasingly mobile society exposes all age groups to the risks of crashes, as passengers, as drivers, and as pedestrians. The automobile is essential for the style of life we demand, and yet, motor vehicle crashes remain a major public health problem. In contemporary society automobiles play an indispensable role in transporting people and goods, and yet, the health care cost of motor vehicle crashes is a national financial burden that must and can be reduced. Worldwide, research and development is underway into systems that link highway infrastructure and telecommunications using emerging technologies via computers, electronics, and advanced sensing systems. While this paper will propose a highway safety counter-measure it will do so after reviewing the policy issues that created the current circumstances connected with occupant safety. Without this review it be impossible to understand the simplicity of the proposed counter-measure. This paper will identify methods for expanding the use of recorded data on highways to improve transportation safety by providing something that has yet to be achieved in the history of the automobile—a simple transportation safety technology capable of reducing fatalities of comparable magnitude. Thus, the primary objective is to technically explain this highway safety countermeasure, designated Seat Belt Event Data Recorder (SB-EDR). A device combining occupant sensing technologies to encourage and monitor seat belt usage within an Event Data Recorder (EDR) is what is required to produce a large change in United States and worldwide auto fatalities. Such a device would do so by achieving something that has eluded motorists to date-- the widespread use of seat belts twenty-four hours a day. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Automatic data collection systems KW - Countermeasures KW - Crash data KW - Economic impacts KW - Event data recorders KW - Externalities KW - Fatalities KW - Highway safety KW - Incentives KW - Injuries KW - Policy KW - Seat belts KW - Sensors KW - Traffic crashes KW - Traffic safety KW - Utilization KW - Vehicle occupants UR - http://www.nhtsa.gov/DOT/NHTSA/NRD/Articles/EDR/PDF/Research/Proactive_use_of_HDR_via_an_EDR_to_achieve_seat_belt_use---.pdf UR - https://trid.trb.org/view/844119 ER - TY - CONF AN - 01088102 AU - Horne, Mike AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Future Video Accident Recorder PY - 1999 SP - pp 165-172 AB - This paper examines the viability and use of video camera systems for accident investigation. While the examples used, and the details explored, are applied to commercial aircraft, the same logic reads across to all public transportation, where safety of passengers is paramount. Specific recent interest from ferry operators, inter-city rail operators, and school bus operators shows that future accident investigations will be heavily dependent on information gathered and recorded by video means. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air transportation crashes KW - Aviation safety KW - Civil aviation KW - Crash data KW - Crash investigation KW - Ferries KW - Future KW - Intercity passenger rail KW - Public transit KW - Rail transit KW - School buses KW - Transit safety KW - Video cameras UR - http://www.iasa.com.au/folders/Publications/pdf_library/horne.pdf UR - https://trid.trb.org/view/844080 ER - TY - CONF AN - 01088101 AU - Grossi, Dennis R AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Aviation Recorder Overview PY - 1999 SP - pp 153-164 AB - There are a wide variety of airborne and ground-based aviation recording devices that can provide vital information for accident prevention purposes. The primary information sources include the mandatory crash-protected flight recorders, airborne quick access data recorders, and ground-based recordings of air traffic control (ATC) radar returns and radio communications. Other sources of recorded information, such as aircraft system internal memory devices and recordings of airline operational communications, have also provided vital information to accident investigators. These devices can range from nonvolatile memory chips to state-of-the-art solid-state flight recorders. With the exception of the mandatory flight recorders, these devices were designed primarily to provide recorded information for maintenance trouble-shooting or specific operational requirements. Regardless of their original purpose, they have all been used in one form or another to investigate aviation accidents. This paper will give an overview of the evolution of flight recorder technology and regulatory requirements, and describe the capabilities and limitations of the various types of recorded information available to the aviation community for accident prevention and, in particular, accident/incident investigation. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air traffic control KW - Air transportation crashes KW - Aircraft operations KW - Automatic data collection systems KW - Aviation safety KW - Computer memory KW - Crash data KW - Crash investigation KW - Data recorders KW - Flight recorders KW - Maintenance KW - Prevention KW - Regulation KW - Solid state devices KW - Technology UR - http://www.iasa.com.au/folders/Publications/pdf_library/grossi.pdf UR - https://trid.trb.org/view/844078 ER - TY - CONF AN - 01088100 AU - Fenwick, Lindsay AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Security of Recorded Information PY - 1999 SP - pp 146-151 AB - Security of recorded information is a highly sensitive issue within the global airline pilot community. This paper emphasizes that adequate security of recorded information is imperative if air safety investigators and other industry professionals are to retain access to recorded data, and other industry professionals are to retain access to recorded data. Although the Air Line Pilots Association is known primarily as a force to improve wages and working conditions for pilots, many familiar with transportation issues are aware of the contributions of ALPA's safety professionals. Our members are vocal with their safety concerns. What our pilots are telling us - and there are about 52,000 of them in the United States and Canada - is that data recordings, and how they are used or abused, continue to be of paramount importance. This paper will discuss issues such as privacy, fairness, trust, legislation, and the need for pilot participation in the analysis of recorded data. For these purposes, recorded information includes not just Cockpit Voice Recorder (CVR) and Cockpit Video View Recorder (CVVR) information, but also Digital Flight Data Recorder (DFDR) information, air safety reports that are electronically transmitted, as well as various forms of data-linked information, including ACARS. In this paper, the security of such information means protection against unauthorized or inappropriate use. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Access KW - Airline pilots KW - Cockpit voice recorders KW - Data analysis KW - Equity (Justice) KW - Flight recorders KW - Legislation KW - Privacy KW - Protection KW - Recording KW - Security KW - Trust (Psychology) KW - Utilization UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844077 ER - TY - CONF AN - 01088099 AU - Durkin, Matthew AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Digital Audio Recorders: Life Savers, Educators, and Vindicators PY - 1999 SP - pp 140-144 AB - “Those who do not remember the past are condemned to repeat it” (George Santayana). What better records of the past are there than those made by recording devices such as the U.S. Navy’s recently developed RD-674A/UNH and RD-681/UNH digital audio recorders? The use of recorders has increased dramatically as the value of recording devices for training and accident investigation and prevention has come to be recognized by both the government and the private sector. The transition from mechanical-based recorders to Personal Computer (PC) based recorders has greatly increased the flexibility and utility of today’s modern recorder. The simple, single-channel audio signal recorders of the past have been superceded by today’s complex multi-channel, analog and digital data recorders, which provide multi-channel simultaneous playback and recording of both digital and analog data. In addition to the ability to store massive amounts of data, this state-of-the-art technology has allowed the Navy’s recorders to evolve from simple documentors of “what was said” to instrumental life-saving tools, educators, simulators, vindicators in the courtroom, and documentors. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Crash investigation KW - Digital audio KW - Education KW - Event data recorders KW - Evidence KW - Personal computers KW - Prevention KW - Search and rescue operations KW - Training KW - Water transportation crashes UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844075 ER - TY - CONF AN - 01088098 AU - Donnelly, Bruce R AU - Schabel, David AU - Blatt, Alan J AU - Carter, Arthur AU - National Transportation Safety Board AU - International Transportation Safety Association TI - The Automated Collision Notification System PY - 1999 SP - pp 125-138 AB - The NHTSA sponsored Automated Collision Notification (ACN) Project was initiated in October 1995 to design, develop, test, and evaluate a system that can detect and characterize crashes and then automatically send a data message to the public safety answering point (PSAP). The system also opens a cellular telephone voice line between the PSAP and the vehicle occupants after the data message has been received. The system detects crashes in all directions and stores the acceleration time history experienced. The ACN system is able to determine the crash change in velocity, the principal direction of crash force, whether a rollover occurred and the potential for injury in the crash. The system also includes GPS equipment and provides PSAP dispatchers with a mapped location of the crash. The ACN system has been installed in 700 vehicles in Western New York and real world crash data and time of EMS response data is being collected and analyzed. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Automatic crash notification KW - Cellular telephones KW - Countermeasures KW - Crash characteristics KW - Crash data KW - Emergency medical services KW - Global Positioning System KW - Highway safety KW - Injuries KW - Public Safety Answering Point (Communications) KW - Traffic crashes KW - Traffic safety UR - http://www.nhtsa.gov/cars/problems/studies/acns/ACN-ntsb-paper.pdf UR - https://trid.trb.org/view/844072 ER - TY - CONF AN - 01088097 AU - Dole, Les AU - National Transportation Safety Board AU - International Transportation Safety Association TI - On-board Recorders: The “Black Boxes” of the Trucking Industry PY - 1999 SP - pp 121-124 AB - From 1995 to 1997, the number of fatalities resulting from accidents involving large trucks increased from 5,091 to 5,355. Most crashes involving automobiles and trucks occur in broad daylight, on straight and dry pavement, during normal weather, and with no indication of alcohol or drug use. In the last four years especially, there has been an outcry across the country from various transportation, safety and trucking groups for a reduction in the number of accidents and deaths on the nation’s highways involving trucks. Ongoing national hearings are being held by the United States House of Representatives Ground Transportation Subcommittee to examine this issue. In the past month, such heavy hitters as National Private Truck Council’s President John McQuaid and Phyllis F. Sheinberg, Associate Director, Transportation Issues, Resources, Community and Economic Development, have been testifying before the committee. The on-board recorder has evolved into a tool that companies can use to help their drivers become safer drivers. The real-time data that these devices generate point up the deficiencies of less skilled drivers and the strengths of safer, more experienced drivers. When combined with safety training, driver incentive programs, and coaching using this data, companies are producing safer drivers. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Abilities KW - Countermeasures KW - Driver experience KW - Event data recorders KW - Fatalities KW - Incentives KW - On board equipment KW - Real time information KW - Training KW - Truck crashes KW - Truck drivers KW - Truck driving KW - Trucking KW - Trucking safety UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844071 ER - TY - CONF AN - 01088096 AU - Dobranetski, Ed AU - Case, Dave AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Proactive Use of Recorded Data for Accident Prevention PY - 1999 SP - pp 99-120 AB - In its railroad accident investigations, the National Transportation Safety Board (NTSB) relies on data recovered from recorders to determine train speed, direction of travel, distance traveled, throttle position, brake application, cab and/or wayside signals, and applicable communications from before and during the accident. Since 1995 the Federal Railroad Administration (FRA) has had the regulatory responsibility for establishing the minimum parameters to be recorded and the standards that event recorders must meet. The railroad industry also voluntarily records information on train movements and warning devices for its own use. This paper will address the use of recorders, the regulations that govern them, the history of the Safety Board’s use of event-recorder data in its investigations, and the future of event recorders in accident investigation. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Brakes KW - Communications KW - Crash investigation KW - Direction of travel KW - Event data recorders KW - History KW - Prevention KW - Railroad crashes KW - Railroad signals KW - Regulations KW - Speed KW - Throttles KW - Trip length KW - Utilization UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844070 ER - TY - CONF AN - 01088095 AU - Chidester, Augustus AU - Hinch, John AU - Mercer, Thomas C AU - Schultz, Keith S AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Recording Automotive Crash Event Data PY - 1999 SP - pp 85-98 AB - The National Transportation Safety Board has recommended that automobile manufacturers and the National Highway Traffic Safety Administration work cooperatively to gather information on automotive crashes using on-board collision sensing and recording devices. Since 1974, General Motors' (GM) airbag equipped production vehicles have recorded airbag status and crash severity data for impacts that caused a deployment. Many of these systems also recorded data during “near-deployment” events, i.e., impacts that are not severe enough to deploy the airbag(s). GM design engineers have used this information to improve the performance of airbag sensing systems and NHTSA researchers have used it to help understand the field performance of alternative airbag system designs. Beginning with the 1999 model year, the capability to record pre-crash vehicle speed, engine RPM, throttle position, and brake switch on/off status has been added to some GM vehicles. This paper discusses the evolution and contents of the current GM event data recording capability, how other researchers working to develop a safer highway transportation system might acquire and utilize the information, and the status of the NHTSA Motor Vehicle Safety Research Advisory Committee’s Event Data Recorder Working Group effort to develop a uniform approach to recording such data. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air bags KW - Brakes KW - Countermeasures KW - Crash analysis KW - Crash causes KW - Crash investigation KW - Crash reconstruction KW - Crash severity KW - Engine performance KW - Event data recorders KW - Highway safety KW - Precrash phase KW - Speed KW - Throttles KW - Traffic crashes KW - Traffic safety UR - http://www.nhtsa.gov/cars/problems/studies/record/chidester.htm UR - https://trid.trb.org/view/844064 ER - TY - CONF AN - 01088094 AU - Carroll, Joseph A AU - Fennell, Michael D AU - National Transportation Safety Board AU - International Transportation Safety Association TI - An Autonomous Data Recorder for Field Testing PY - 1999 SP - pp 61-66 AB - Progress in the development of miniature sensors, microprocessors, compact nonvolatile “flash” memory, and battery technology allows the design of sophisticated miniature autonomous data recorders for a wide variety of inter-modal transportation applications. In some cases, requirements for data recorders are well known or already specified by law. However, in new applications for data recorders, it is not always apparent what parameters need to be measured, nor with what frequency or precision. It may be useful in early field tests to collect more data than might be justified in an operational system, to allow assessment of what data is actually most useful. Since early field tests often involve retrofit into existing vehicles, it is also useful for a field-test recorder to have its own sensors, to simplify installation. This can also enable “fleet surveys” in which a few recorders are moved from one vehicle to another. Small autonomous data recorders are also useful for gathering data during vehicle testing. In some cases they may find use supplementing conventional data recorders, because they can be distributed throughout a large vehicle with little or no wiring. Tether Applications has designed a Small Intelligent Datalogger (SID) with a variety of unusual features, including multiple on-board sensors, on-board alarm clocks for low-duty-cycle operation, and several serial-interface networking options. Its original purpose was as the core of some very small, low-cost, low-power spacecraft, but it also appears relevant for a variety of applications requiring small autonomous data recorders. It appears particularly well suited to early field-testing, where programming, installation, data recovery, and data analysis are likely to cost far more than purchase of the recorders themselves. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Data collection KW - Data recorders KW - Event data recorders KW - Field tests KW - Flight recorders KW - Sensors UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844047 ER - TY - CONF AN - 01088093 AU - Brown, Michael T AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Marine Voyage Data Recorders PY - 1999 SP - pp 47-60 AB - “Data recorders” in some form have been around for quite some time in the marine industry. They include, but are not limited to, log books, navigation charts, bell or engine order logs, course recorders, hull stress meters, propulsion and auxiliary engine computer logs, vessel traffic service (VTS) systems, Rescue Coordination Center (RCC) radio transmission tapes, and the Automatic Identification System (AIS). A marine voyage data recorder (VDR) centralizes the various measurements taken on board a vessel in one “protective” place from which data can be retrieved at a later date for analysis. Many companies have already taken the initiative of installing VDRs not only to obtain data in the event of an accident or incident, but also to assist in managing their fleets. This paper will review the history of VDRs, specifically their promotion by the National Transportation Safety Board (NTSB), the International Maritime Organization’s (IMO’s) actions and its pending carriage requirements, the International Safety Management (ISM) code requirements, IEC performance standards, the position of the classifications societies on VDRs, the VDR and Port State control, VDRs in international investigations, and operational management requirements of the ship owner. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - History KW - Maritime safety KW - Performance KW - Ship navigational aids KW - Standards KW - Voyage data recorders KW - Water transportation UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844013 ER - TY - CONF AN - 01088092 AU - Brooks, Jeffrey L AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Smiths Industries Flight Data/Cockpit Voice Recorders PY - 1999 SP - pp 35-45 AB - This paper is intended to provide an avionics manufacturer’s industry perspective of modern recording and diagnostic monitoring systems for aircraft applications. Smiths Industries Voice And Data Recorder (VADR®) product line combines reliable, rugged, entirely solid-state technology with proven data recording expertise available in a variety of packages. The VADR® product family consists of Cockpit Voice Recorders (CVRs), Flight Data Recorders (FDRs), combined function (CVR & FDR) recorders, and Integrated Data Acquisition And Recorder System (IDARS) and Health and Usage Monitoring Systems (HUMS) equipment. All models are Authorized to Federal Aviation Administration (FAA) TSO-C123a and TSO-C124a performance requirements, and also meet the functional and performance standards of European Organization for Civil Aviation Electronics (EUROCAE) ED-55 and ED-56A. The company’s flight data recorders are fitted to over 6,700 military aircraft and became the US Air Force and US Navy standard for all aircraft in 1988. The US Army, US Coast Guard, Federal Aviation Administration, and many civil and allied nations’ military fleets also make extensive use of Smiths Industries recorder products and systems. Compact, light weight, and affordable, the VADR® is applicable to virtually any aircraft, offering a unique advantage to those aircraft previously constrained by the weight and bulk of traditional data recording systems. The VADR® single box solution measures 3.4”H x 4.25”W x 7.5”D (8.6cm x 10.8cm x 19.0cm) and weighs 6.5 to 9.3 pounds (2.9 to 4.2 kilograms), depending upon configuration. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Aviation safety KW - Civil aircraft KW - Cockpits KW - Flight recorders KW - Health and usage monitoring system (HUMS) KW - Military aircraft KW - Performance KW - Products KW - Standards KW - Voice recorders UR - http://www.iasa.com.au/folders/Publications/pdf_library/brooks.pdf UR - https://trid.trb.org/view/843857 ER - TY - CONF AN - 01088091 AU - Brandt, Mads H AU - National Transportation Safety Board AU - International Transportation Safety Association TI - The Next Generation FOQA Programs PY - 1999 SP - pp 29-34 AB - The reason why the aircraft accident rate has stayed fairly flat since the mid-70’ has caused many to speculate as to why. First of all, - is it at an acceptable level? or is “Zero Accidents” an attainable goal to strive for. We must always as an industry strive for “Zero Accidents”. The increase in traffic density over the next ten to fifteen years is bound to have an effect, not only on the rate, but the number of accidents. The numbers we are looking at are unacceptable. What has kept the accident rate flat since the mid-70's is better flight training programs with the introduction of LOFT and Cockpit Resource Management programs and the introduction of GPWS and TCAS. The value that these programs have added to further reduce accidents has been exhausted as indicated by the persistent flat accident rate. One of the yet un-exploited tools is Flight Operational Quality Assurance or FOQA. The goal of FOQA programs is to provide airline managers with information that will enable them to better understand risks to flight operation and how to manage risk. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air traffic KW - Air transportation crashes KW - Aviation safety KW - Crash rates KW - Flight Operational Quality Assurance Program KW - Flight recorders KW - Risk management KW - Traffic density UR - http://www.iasa.com.au/folders/Publications/pdf_library/brandt.pdf UR - https://trid.trb.org/view/843856 ER - TY - CONF AN - 01088090 AU - Bolduc, Carole AU - Jackson, Wayne AU - National Transportation Safety Board AU - International Transportation Safety Association TI - 3D Animation of Recorded Flight Data PY - 1999 SP - pp 21-28 AB - Three-dimensional animation technology has been used for many years for accident investigation purposes. With the advent of faster, lower cost personal computers this technology is now available to multiple individuals at airlines as a cost-effective enhancement for Flight Data Monitoring (FDM) and Flight Operational Quality Assurance (FOQA) programs. Aircraft animations with synchronized cockpit instrumentation are an effective means of presenting results, and drawing cause-effect relationships from recorded flight data. The animation of an event encompasses the aircraft’s flight profile, cockpit instrumentation, terrain and scenario data. With an increasing number of parameters being recorded on aircraft, a method of relaying the large amounts of available information in a meaningful manner is needed. 3D animations are one such method. Furthermore, 3D animation capabilities are now accessible to multiple end-users from their desktop PC. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air transportation crashes KW - Aircraft KW - Aircraft operations KW - Aviation safety KW - Cockpits KW - Computer animation KW - Crash investigation KW - Crash reconstruction KW - Flight data monitoring KW - Flight paths KW - Flight recorders KW - Instrumentation KW - Terrain KW - Three dimensional displays UR - http://www.iasa.com.au/folders/Publications/pdf_library/bolduc.pdf UR - https://trid.trb.org/view/843855 ER - TY - CONF AN - 01088089 AU - Austin, P Robert AU - National Transportation Safety Board AU - International Transportation Safety Association TI - The Use of Deployable Flight Recorders in Dual Combi Recorder Installations PY - 1999 SP - pp 9-20 AB - Flight Data Recorders (FDR’s), Cockpit Voice Recorders (CVR’s) and Emergency Locator Transmitters (ELT’s) have been combined into a single deployable unit and used successfully on military aircraft for decades. Their proven survival strategy, of deploying away from the aircraft and hence the crash site, allows for quick location and economical recovery of recorder information, particularly in marine incidents, where the floating recorders can readily be retrieved from the surface of the ocean. Changes in the needs of accident investigators, and in aircraft use, application, performance monitoring, routing, and avionics have resulted in the current initiatives underway to revise aviation recorder standards. The deliberations of EUROCAE Working Group 50 and the discussions of the group preparing the new AEEC standard of ARINC 767 are airing some radically new concepts in flight recorder requirements and configurations. These include the use of a pair of redundant recorders each storing both Cockpit Voice, Flight Data, and requirements for digital communications and video storage. In this process of reviewing, revising and adding to airborne recorder standards, there is reason to evaluate the use of deployable recorders on civilian aircraft. An opportunity has arisen for the use of a deployable recorder as the alternate recorder in dual redundant recorder installations. This combination of recorder memory media protection schemes would provide the best of both worlds of fixed and deployable survivability strategies. As the new EUROCAE specifications pass from embryonic concepts to regulation it is important that matching airworthiness standards levied by the FAA, JAA and other authorities continue to include standards for deployables. Definition and regulation of requirements for deployables, such as those included in the performance specifications being drafted by Working Group 50, would allow the option for the use of a fixed and deployable combined recorder installation on civil aircraft. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air transportation crashes KW - Aviation safety KW - Civil aircraft KW - Combination data recorders KW - Crash investigation KW - Deployable KW - Emergency locator transmitters KW - Flight recorders KW - Military aircraft KW - Standards KW - Water transportation crashes UR - http://www.iasa.com.au/folders/Publications/pdf_library/austin.pdf UR - https://trid.trb.org/view/843825 ER - TY - CONF AN - 01088088 AU - A'Harrah, Ralph AU - Kaseote, George AU - National Transportation Safety Board AU - International Transportation Safety Association TI - A Case for Higher Data Rates PY - 1999 SP - pp 1-8 AB - Flight data recorders required to support aviation accident investigations have benefited from numerous advances in recorder technology. These numerous technology advances for the most part have been directed at increasing the number of recorded parameters, improving the recording media, and improving reliability, maintainability, survivability and recovery characteristics. While these several aspects of the recorders have been improved, there has not been an associated increase in the once-per-second (1.0 Hz.) rate at which the flight data is recorded for accident analysis. This once-per-second rate has persisted in spite of the fact that technology advances could support much higher data rates, as demonstrated by rates of 20 to 100 data points per second (20 to 100 Hz) of current flight test data recordings. The need for a data rate above one data point per second evidently has not been conclusively established for accident analysis. While the aviation accident rate is rewardingly low, the aviation accident rate has remained stubbornly unchanged for the past two decades in spite of the billions of dollars invested for safety improvement. The following review of the accident data for the most recent ten-year period for which data is available, may provide some insight as to a potential reason for our inability to further improve our aviation accident rate. During the period from 1988 through 1997, the worldwide commercial jet fleet experienced 213 hull loss accidents. For 105 of these accidents, or 49% of the total accidents, the “flight crew” was listed as the primary causal factor. An additional 64 accidents, or 30%, listed “unknown” as the primary causal factor. These statistics indicate that nearly 80% of the hull loss accidents for the most recent ten year period are the results of causal factors for which there is incomplete understanding of exactly what problems need to be solved. Can there be a credible expectation for reducing the accident rate by 80% within ten years when 80% of the causal factors aren’t well understood? The intent of this paper is to demonstrate the need, and argue for the establishment of data rate requirements at least an order of magnitude greater than today’s requirements for selected parameters under particular conditions, and to describe the potential benefits that would be derived from the increased data rates. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air transportation crashes KW - Aviation safety KW - Crash analysis KW - Crash causes KW - Crash data KW - Data rate KW - Flight recorders UR - http://www.iasa.com.au/folders/Publications/pdf_library/aharrah.pdf UR - https://trid.trb.org/view/843824 ER - TY - CONF AN - 01088087 AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Proceedings of the International Symposium on Transportation Recorders. Transportation Recording: 2000 and Beyond, May 3-5, 1999, Arlington, Virginia PY - 1999 SP - 386p AB - The conference on transportation recording was held in Arlington, Virginia from May 3-5, 1999. It reviews the state of knowledge of data recorders, and considers how to better exploit data from on-board recordings the future to aid in promoting transportation safety. Data recorders in aviation, highway transportation and water transportation are discussed. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Air transportation crashes KW - Aviation safety KW - Conferences KW - Countermeasures KW - Crash analysis KW - Event data recorders KW - Flight recorders KW - Highway safety KW - Maritime safety KW - Traffic crashes KW - Water transportation crashes UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/843820 ER - TY - CONF AN - 01088086 AU - Warnfeldt, Sten AU - National Transportation Safety Board AU - International Transportation Safety Association TI - How Can the VDR Prevent Accidents and Improve the Safety of a Vessel? PY - 1999 SP - pp 351-355 AB - This paper will present how easy it is to retrieve the information from a shipborne voyage data recorder (VDR), using the desktop computer at the office. One can review real events that are recorded and stored on board a vessel. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Information retrieval KW - Maritime safety KW - Personal computers KW - Prevention KW - Real time information KW - Ships KW - Voyage data recorders KW - Water transportation crashes UR - http://www.ntsb.gov/doclib/reports/1999/RP9901.pdf UR - https://trid.trb.org/view/844154 ER - TY - CONF AN - 01088048 AU - Menig, Paul AU - Coverdill, Cary AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Transportation Recorders on Commercial Vehicles PY - 1999 SP - 14p AB - Information has been sensed, recorded and off loaded from commercial vehicles for almost twenty years, excluding the recording of speed by tachographs. The recording devices include trip recorders, engine controls, on-board computers, wireless communications equipment, RADAR collision warning devices and instrument clusters. The information is used to improve driver safety, help diagnose problems, improve the efficiency of logistics for the fleet, and reduce operating costs. This paper will provide a brief history of recorders on commercial vehicles, an overview of presently available products, examples of the information available, and a projection of future recording capabilities. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Commercial vehicle operations KW - Commercial vehicles KW - Computers KW - Crash avoidance systems KW - Event data recorders KW - Future KW - History KW - Instrumentation KW - Logistics KW - On board equipment KW - Operating costs KW - Products KW - Radar KW - Travel KW - Truck drivers KW - Trucking safety KW - Vehicle fleets KW - Warning devices KW - Wireless communication systems UR - http://www.nhtsa.gov/DOT/NHTSA/NRD/Articles/EDR/PDF/Research/Transportation_Recorders_on_Commercial_Vehicles.pdf UR - https://trid.trb.org/view/844234 ER - TY - CONF AN - 01088046 AU - Evans, Gregory L AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Transportation Event Recorder Data: Balancing Federal Public Policy and Privacy Rights PY - 1999 SP - 4p AB - The public interest in gathering data from event recorders can be harmonized with the ownership rights which railroads have in such data. If railroad safety is to be advanced in our nation, data available from event recorders on trains involved in major accidents must be provided to the National Transportation Safety Board (NTSB) and the Federal Railroad Administration. Railroad safety is enhanced through analysis of valid event recorder data. Existing law governing the production of event recorder data should be clarified, however, to facilitate a railroad's immediate use of event recorder data and to minimize service delays. Railroads are sometimes prevented from retrieving event recorder data immediately following an accident because federal investigators believe they are authorized to order railroads not to touch anything involved in the accident, including event recorder data, until they arrive. Existing law allows NTSB to conduct investigations without interfering with railroad operations. The same law instructs NTSB to conduct investigations in any manner designed to preserve all evidence to the maximum extent feasible, and mandates the cooperation of railroads. NTSB's contradictory regulations lead to frequent misunderstandings between railroads and NTSB during the response to many major accidents. This article briefly discusses this issue as it relates to event recorder data, and recommends clarification in NTSB regulations. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Crash data KW - Crash investigation KW - Data analysis KW - Event data recorders KW - Federal government agencies KW - Intergovernmental relations KW - Laws KW - Legal rights KW - Policy KW - Privacy KW - Railroad crashes KW - Railroad safety KW - Regulations KW - U.S. Federal Railroad Administration KW - U.S. National Transportation Safety Board UR - http://www.ntsb.gov/doclib/reports/1999/rp9901.pdf UR - https://trid.trb.org/view/844231 ER - TY - CONF AN - 01088026 AU - Lehmann, Gerhard AU - Reynolds, Tony AU - National Transportation Safety Board AU - International Transportation Safety Association TI - The Contribution of Onboard Recording Systems to Road Safety and Accident Analysis PY - 1999 SP - 6p AB - This paper presents onboard computer systems (black boxes), that 1. contribute to road safety by helping to reduce the number of accidents, 2. provide data for accident analysis based on field experiences in USA and Europe with case studies. There are several versions of onboard computers that record the performance of drivers and vehicles. Field experiences and case studies show that a ‘feed back’ of these records lead to a favourable modification of drivers’ behaviour. Further these objective and accurate recordings allow detailed reconstruction and analysis of accidents. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Behavior KW - Case studies KW - Countermeasures KW - Crash analysis KW - Crash data KW - Crash investigation KW - Crash reconstruction KW - Drivers KW - Europe KW - Event data recorders KW - Highway safety KW - Traffic crashes KW - Traffic safety KW - United States KW - Vehicles UR - http://www-nrd.nhtsa.dot.gov/pdf/Esv/esv16/98S2O34.PDF UR - https://trid.trb.org/view/844232 ER - TY - CONF AN - 01087993 AU - Mann, Lawrence M AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Privacy, Proprietary And Union Issues Regarding Rail Recording Systems PY - 1999 SP - 5p AB - This paper will analyze legal issues regarding event recorders in the railroad industry, and union perspective on the use of recorder information. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Event data recorders KW - Labor unions KW - Legal factors KW - Privacy KW - Railroads KW - Utilization UR - http://www.ntsb.gov/events/symp_rec/proceedings/authors/mann.pdf UR - https://trid.trb.org/view/844233 ER - TY - CONF AN - 01087949 AU - Nagala, Daniel W AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Future Recording Requirements and Capabilities in the Oil and Gas Pipeline Industry: Turning Science Fiction into Practical Applications PY - 1999 SP - 5p AB - In the early morning hours of a summer day in the southeastern United States, the President of a transmission pipeline company receives an emergency call informing him that there has been a substantial rupture in one of the company’s pipelines. Precise details are not known, however, emergency personnel and company response teams have already been dispatched, and the appropriate agencies are being contacted. As one might expect, the first priorities in a situation like this are to stabilize the location and to isolate the subject pipeline to eliminate the possibility of secondary damage related to the incident. However, what happens after the initial response, repair, and cleanup may not always be as clear-cut as one might hope. Questions such as – What caused the problem? Could it have been avoided? Did the company’s operations personnel respond rapidly, and according to a predetermined protocol? – are but a few examples of what must be determined before conclusions can be reached. It seems that there are always more questions than there are answers in these kinds of situations. The task of investigation and analysis can be tedious, time consuming, and may not provide definitive closure to many of these questions. But does it have to be this way? Future developments may provide ways for these questions to be answered quickly, and allow for implementation of proactive techniques and procedures that will promote rapid response and greater probability of avoidance. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Crash analysis KW - Crash data KW - Crash investigation KW - Data recorders KW - Future KW - Gas pipelines KW - Oils KW - Pipeline accidents KW - Pipeline safety KW - Pipelines KW - Rupture UR - http://www.powershow.com/view/14fa4d-NGU0N/Future_Recording_Requirements_and_Capabilities_in_the_Oil_and_Gas_Industry_powerpoint_ppt_presentation UR - https://trid.trb.org/view/844238 ER - TY - CONF AN - 01087885 AU - Bolte, Kristin AU - Jackson, Lawrence AU - Roberts, Vernon AU - McComb, Sarah AU - National Transportation Safety Board AU - International Transportation Safety Association TI - Accident Reconstruction/Simulation With Event Recorders PY - 1999 SP - n.p. AB - In 1997, 42,000 people were killed in highway accidents in the United States. The exact cause of an accident is often unknown and, therefore, conclusions relating to the safety afforded by the vehicle to the occupant cannot be made. In addition, safety hazards in the highway environment are often not discovered due to the lack of information. Accident reconstruction is a tool commonly used by the National Transportation Safety Board (NTSB) to investigate the accident sequence, but data are often lacking and accurate reconstructions are difficult and time-consuming. Because many assumptions are made in this process, the reconstruction is not exact, making it difficult to accurately predict occupant kinematics and to identify potential safety hazards within the vehicles. Vehicle recorders would eliminate much of the guesswork involved in reconstructing accidents, enabling a more accurate assessment of occupant injuries, driver performance, and safety hazards within and around a vehicle. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Countermeasures KW - Crash causes KW - Crash data KW - Crash investigation KW - Crash reconstruction KW - Drivers KW - Event data recorders KW - Fatalities KW - Hazards KW - Highway safety KW - Injuries KW - Kinematics KW - Performance KW - Simulation KW - Traffic crashes KW - Traffic safety KW - U.S. National Transportation Safety Board KW - United States KW - Vehicle occupants KW - Vehicle safety UR - http://www.ntsb.gov/events/symp_rec/proceedings/posters/bolte/bolte.htm UR - https://trid.trb.org/view/844239 ER - TY - CONF AN - 00925854 AU - CHAMPION, H R AU - AUGENSTEIN, J S AU - CUSHING, B AU - DIGGES, K H AU - Hunt, R AU - Larkin, R AU - Malliaris, A C AU - Sacco, W J AU - SIEGEL, J H AU - National Transportation Safety Board AU - International Transportation Safety Association TI - REDUCING HIGHWAY DEATHS AND DISABILITIES WITH AUTOMATIC WIRELESS TRANSMISSION OF SERIOUS INJURY PROBABILITY RATINGS FROM CRASH RECORDERS TO EMERGENCY MEDICAL SERVICES PROVIDERS PY - 1999 SP - pp 67-84 AB - The National Transportation Safety Board (NTSB) has issued recommendations for crash recorders (H-97-18 and H-97-21) and for increasing funding for motor vehicle safety efforts at the State level (H-96-13). This paper addresses the building of a national Automatic Lifesaving System based on these pioneering NTSB recommendations to realize the full potential of new technologies as soon as possible. The work described in this paper is the result of efforts of a multidisciplinary team of trauma surgeons, emergency physicians, crashworthiness engineers and statisticians. The team examined the safety potential of communicating crash recorder data via wireless telecommunications with Automatic Crash Notification technology to improve emergency transport and treatment of crash victims. U1 - Transportation Recording: 2000 and Beyond. International Symposium on Transportation RecordersNational Transportation Safety BoardInternational Transportation Safety AssociationArlington,VA,United States StartDate:19990503 EndDate:19990505 Sponsors:National Transportation Safety Board, International Transportation Safety Association KW - Automatic crash notification KW - Emergency medical services KW - Emergency response time KW - Injury severity KW - Lifesaving KW - Traffic crashes KW - Wireless communication systems UR - http://www-nrd.nhtsa.dot.gov/pdf/nrd-01/esv/esv18/cd/files/18esv-000406.pdf UR - https://trid.trb.org/view/720154 ER - TY - RPRT AN - 00896108 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: DERAILMENT OF CSX FREIGHT TRAIN Q316 AND SUBSEQUENT HAZARDOUS MATERIAL RELEASE AT COX LANDING, WEST VIRGINIA, JUNE 20, 1998. PY - 1999 IS - PB99-916301 AB - No abstract provided. KW - Cox landing KW - Hazardous materials KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9901.pdf UR - https://trid.trb.org/view/612541 ER - TY - RPRT AN - 00896220 AU - National Transportation Safety Board AU - NORTHERN INDIANA COMMUTER TRANSPORTATION DISTRICT. TI - NORTHERN INDIANA COMMUTER TRANSPORTATION DISTRICT RAILROAD SAFETY ASSESSMENT. PY - 1999 AB - No abstract provided. KW - Indiana KW - Railroad crashes KW - Railroads UR - http://app.ntsb.gov/doclib/reports/1999/SIR9903.pdf UR - https://trid.trb.org/view/612557 ER - TY - RPRT AN - 00896109 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION OF NORFOLK SOUTHERN CORPORATION TRAIN 255L5 WITH CONSOLIDATED RAIL CORPORATION TRAIN TV 220, BUTLER, INDIANA, MARCH 25, 1998. PY - 1999 IS - PB99-916302 AB - No abstract provided. KW - Butler (Indiana) KW - Locomotive engineers KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9902.pdf UR - https://trid.trb.org/view/612542 ER - TY - RPRT AN - 01003100 AU - National Transportation Safety Board TI - Marine Accident Report: Capsizing of U.S. Fishing Vessel Evanick near Kodiak, Alaska, April 25, 1998 PY - 1998/12/15 SP - 3p AB - On April 24, 1998, in preparation for a 650-mile voyage to herring fishing grounds near Togiak, Alaska, the fishing vessel Evanick's 17-foot-long, 5,000-pound skiff, which was used for handling the fishing nets, was stowed on the vessel's after deck. This stowage configuration raised the vessel's center of gravity, reducing its stability. Between 0700 and 1128 on April 25, 1998, the Evanick, with four crewmembers, capsized in the Shelikof Strait while en route to the fishing grounds. The National Weather Service had issued a gale warning for the area at 0910. Seas at the time of the accident were 12 to 16 feet, winds were south at 30 knots, and the water temperature was 39 deg F. The U.S. Coast Guard search and rescue aircraft, responding to a distress signal from the vessel, arrived within 2 hours and located the Evanick floating in a capsized condition. There were no signs of the crew. In subsequent search operations, no crewmember of the Evanick was found. The crewmembers' four immersion suits were found still packaged in bags in a locker on the Evanick's bridge. The vessel's hull and superstructure were undamaged, but the vessel's aft starboard handrail was damaged where the skiff had been secured. Because the floating Evanick constituted a hazard to navigation, it was purposely sunk by the Coast Guard. The National Transportation Safety Board determines that the probable cause of the capsizing of the Evanick was the fishing vessel's less-than-adequate stability for the sea conditions. Contributing to the loss of life was the probable suddenness of the capsizing, which did not afford the crew time to don their immersion suits before they entered the water. KW - Alaska KW - Capsizing KW - Center of gravity KW - Crash causes KW - Crash investigation KW - Crash reports KW - Drowning KW - Fishing vessels KW - Frigid regions KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB9802.pdf UR - https://trid.trb.org/view/759366 ER - TY - RPRT AN - 00816407 AU - National Transportation Safety Board TI - HAZARDOUS MATERIALS ACCIDENT SUMMARY REPORT: FAILURE OF TANK CAR TEAX 3417 AND SUBSEQUENT RELEASE OF LIQUEFIED PETROLEUM GAS, PASADENA, TEXAS, NOVEMBER 22, 1997 PY - 1998/12/01 SP - 27 p. AB - On November 22, 1997, a frost ring that signified product leakage was discovered on the bottom center of a tank car that was being unloaded at the Georgia Gulf Corporation chemical plant in Pasadena, Texas. The tank car contained 29,054 gallons of a propylene/propane mixture, a liquefied flammable gas. The tank car had been purged with cryogenic nitrogen on October 17, about a month before the accident. No injuries or fatalities were reported as a result of the failure of the tank car. Georgia Gulf estimated that approximately 52 gallons of the cargo were released. Total damage, including the cost of the clean up, loss of product, and repair of the tank car, was estimated to be slightly less than $9,300. The safety issues discussed in this report are the need to safeguard tank cars adequately when they are being purged with nitrogen and the use of engineering analyses of the properties of tank car steels in the development of industry-recommended procedures for the purging of tank cars with nitrogen. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Compressed Gas Association, Inc., the Federal Railroad Administration, and the Association of American Railroads. KW - Crash reports KW - Cryogenic nitrogen KW - Failure KW - Hazardous materials KW - Leakage KW - Liquefied petroleum gas KW - Pasadena (Texas) KW - Purging KW - Recommendations KW - Safety KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZM9801S.pdf UR - https://trid.trb.org/view/690721 ER - TY - RPRT AN - 00789130 AU - National Transportation Safety Board TI - HIGHWAY SPECIAL INVESTIGATION REPORT: TRANSIT BUS SAFETY OVERSIGHT PY - 1998/11/17 SP - 24 p. AB - After the National Transportation Safety Board conducted several accident investigations involving transit buses (Normandy, Missouri; Cosmopolis, Washington; New York, New York; and Nashville, Tennesee) and held a public hearing on transit bus safety in March 1998, it found that substantial safety deficiencies and little Federal or State government safety oversight existed within the transit bus industry. During the public hearing, participants discussed transit agency self-regulation, the extent of Federal and State safety oversight, accident data, pupil transportation, and driver selection and qualification. The findings from the public hearing and from the four accident investigations formed the basis for this special investigation report. The safety issues discussed in this report are the Federal and State safety oversight of transit bus operations, adequacy of transit bus accident data to identify potential safety issues, and safety program guidelines for transit operators. As a result of its investigation, the National Transportation Safety Board issued recommendations to the U.S. Department of Transportation, American Public Transit Association, Community Transportation Association of America, and American Association of State Highway and Transportation Officials. KW - Bus crashes KW - Bus drivers KW - Bus transit KW - Bus transit operations KW - Crash data KW - Guidelines KW - Oversight KW - Public transit KW - Qualifications KW - Recommendations KW - Safety programs KW - School children KW - Traffic safety KW - Transit buses KW - Transit operators UR - http://ntl.bts.gov/lib/9000/9800/9881/SIR9803.pdf UR - http://ntl.bts.gov/lib/9000/9800/9881/SIR9803.pdf UR - https://trid.trb.org/view/647664 ER - TY - RPRT AN - 00759606 AU - National Transportation Safety Board TI - HIGHWAY SPECIAL INVESTIGATION REPORT. TRANSIT BUS OVERSIGHT PY - 1998/11/17 SP - 18 p. AB - After the National Transportation Safety Board conducted several accident investigations involving transit buses and held a public hearing on transit bus safety in March 1998, it found that substantial safety deficiencies and little Federal or State government safety oversight existed within the transit bus industry. During the public hearing, participants discussed transit agency self-regulation, the extent of Federal and State safety oversight, accident data, pupil transportation, and driver selection and qualification. The findings from the public hearing and from the four accident invesigations formed the basis for this special investigation report. The safety issues discussed in this report are the Federal and State safety oversight of transit bus operations, adequacy of transit bus accident data to identify potential safety issues, and safety program guidelines for transit operators. KW - Crash data KW - Crash investigation KW - Oversight KW - Public hearings KW - Safety programs KW - School buses KW - Transit buses UR - https://trid.trb.org/view/495974 ER - TY - RPRT AN - 00764859 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT ICING ENCOUNTER AND UNCONTROLLED COLLISION WITH TERRAIN COMAIR FLIGHT 3272 EMBRAER EMB-120RT, N265CA, MONROE, MICHIGAN, JANUARY 9, 1997 PY - 1998/11/04 SP - 360 p. AB - This report explains the accident involving an EMB-120 RT, operated by COMAIR Airlines, Inc., as flight 3272, that crashed during a rapid descent after an uncommanded roll excursion near Monroe, Michigan, on January 9, 1997. Safety issues in the report focused on procedures for the use of ice protection systems, airspeed and flap configuration information, stall warning/protection system capabilities, operation of the autopilot in icing conditions, aircraft icing certification requriements, and icing-related research. Safety recommendations concerning these issues were addressed to the Federal Aviation Administration and the National Aeronautics and Space Administration. KW - Air transportation crashes KW - Airspeed KW - Automatic pilot KW - Certification KW - Flaps (Aircraft) KW - Icing KW - Research KW - Stall KW - Warning systems (Aircraft) UR - https://trid.trb.org/view/501913 ER - TY - RPRT AN - 01139222 AU - National Transportation Safety Board TI - Railroad Accident Brief Report: LAX 96 FR 010 Derailment and Hazardous Materials Release with Fatality, Montana Rail Link, Alberton, Montana, April 11, 1996 PY - 1998/08/18 SP - 2p AB - About 4:10 a.m., mountain daylight time, on April 11, 1996, 19 cars from Montana Rail Link (MRL) freight train 01-196-10 derailed near Alberton, Montana. Six of the derailed cars contained hazardous materials. One derailed tank car containing chlorine (a poison gas) ruptured, releasing 130,000 pounds of chlorine into the atmosphere; another tank car containing potassium hydroxide solution (potassium cresylate, a corrosive liquid) lost 17,000 gallons of product; and a covered hopper car containing sodium chlorate (an oxidizer) spilled 85 dry gallons onto the ground. About 1,000 people from the surrounding area were evacuated. Approximately 350 people were treated for chlorine inhalation, 123 of whom sustained injury. Nine people, including both members of the train crew, were hospitalized. A transient riding the train died from acute chlorine toxicity. U.S. Interstate Highway 90 (I-90) is roughly parallel and about 150 yards north of the MRL tracks at the accident site. The hazardous material cloud drifted across I-90 resulting in multiple highway traffic accidents. Several motorists were stranded in the cloud after these accidents. I-90 was closed following the accident requiring an 81-mile detour. Monetary damage was estimated to be $3.9 million. The Governor of Montana declared a state of emergency in Missoula and Mineral County. On April 14, 1996 the evacuation area was reduced to 15 square miles; the residents were temporarily escorted into the area to feed and water livestock animals, retrieve some personal possessions, and locate pets. The National Transportation Safety Board determines that the probable cause of this accident was a rail section that fractured in vertical split head mode under the passing train induced by rail with reduced load bearing capacity because of head and gage face wear. Contributing to the cause of the accident was the inability of the ultrasonic rail defect detection equipment to readily identify internal defects in rail with surface defects. KW - Crash causes KW - Crash investigation KW - Derailments KW - Hazardous materials KW - Montana KW - Railroad crashes KW - Railroad safety KW - Spills (Pollution) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB9807.pdf UR - https://trid.trb.org/view/898604 ER - TY - RPRT AN - 01139213 AU - National Transportation Safety Board TI - LAX 96 FR 007 Derailment and Hazardous Materials Release, Southern Pacific Lines, Tennessee Pass, Colorado, February 21, 1996 PY - 1998/08/18 SP - 2p AB - On February 21, 1996 at about 5:55 a.m., mountain standard time, Southern Pacific Lines freight train 1ASRVM-18 derailed 39 cars and 2 locomotives while descending the Tennessee Pass, a 3.0 percent grade in the Rocky Mountains of Colorado. The train’s three-member traincrew consisted of a locomotive engineer, a student locomotive engineer, and a conductor. According to the conductor, the train was being operated by the student engineer. As the train started the mountainous descent it began gaining speed and eventually ran away. The runaway train broke apart three different times, resulting in three separate derailments. The derailment resulted in the death of both engineers. The conductor, who was in the second locomotive unit during the runaway, survived with serious injuries. As a result of the derailment 51,606 gallons of sulfuric acid and 19,733 gallons of triethylene glycol, both regulated hazardous materials, were released. Four family members living on a nearby farm were evacuated from the area. Monetary damage was estimated to be $6.8 million. Postaccident brake tests and inspections at the accident site and subsequent bench and laboratory tests revealed no equipment failures. The locomotive event recorder had documented brake pipe pressures at both the front and rear of the train. Investigators concluded that the brake pipe was operative throughout the train, without restriction, both prior to and during the runaway. There were no compromises of the integrity of the train brake system. The National Transportation Safety Board determines that the probable cause of this accident was the mismanagement of the air brake system by the student engineer, allowing the speed of the train to increase to the point where the brake system no longer had the ability to stop the train, and the failure of the locomotive engineer to ensure proper train control. KW - Crash causes KW - Crash investigation KW - Derailments KW - Hazardous materials KW - Railroad safety KW - Spills (Pollution) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAB9808.pdf UR - https://trid.trb.org/view/898600 ER - TY - RPRT AN - 00753758 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: MULTIPLE VEHICLE CROSSOVER ACCIDENT, SLINGER, WISCONSIN, FEBRUARY 12, 1997 PY - 1998/07/24 SP - 79 p. AB - About 5:52 a.m. on February 12, 1997, a doubles truck that was traveling northbound on U.S. Route 41 near Slinger, Wisconsin, lost control and crossed over the median into the southbound lanes. A flatbed truck traveling southbound on U.S. Route 41 collided with the doubles truck, lost control, and crossed over the median into the northbound lanes. A northbound passenger van struck and underrode the right front side of the flatbed truck. A refrigerator truck struck the right rear side of the flatbed truck. Eight persons suffered fatal injuries. The safety issues discussed in this report are: judgment and experience of the doubles truckdriver; stability of doubles trucks; effectiveness of snow and ice removal; adequacy of the American Association of State Highway and Transportation Officials (AASHTO) divided freeway median barrier warrants; adequacy of the States' accident report forms to capture cross-median accident data; and availability and use of restraints. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Federal Highway Administration, the National Highway Traffic Safety Administration, the National Association of Governors' Highway Safety Representatives, the International Brotherhood of Teamsters, the AASHTO, the Wisconsin Department of Transportation, the Independent Truckers and Drivers Association, the National Private Truck Council, and the Owner-Operators Independent Drivers Association, Inc. The Safety Board reiterated one recommendation to the State of Wisconsin. KW - Crash investigation KW - Crash reports KW - Double trailers KW - Fatalities KW - Forms (Documents) KW - Loss of control KW - Loss of control accidents KW - Median barriers KW - Motor vehicles KW - Multiple vehicle crashes KW - Personnel performance KW - Seat belt usage KW - Seat belts KW - Snow and ice control KW - Stability (Mechanics) KW - Tractor trailer combinations KW - Truck crashes KW - Truck drivers UR - http://ntl.bts.gov/lib/9000/9700/9759/HAR9801.pdf UR - http://ntl.bts.gov/lib/9000/9700/9759/HAR9801.pdf UR - https://trid.trb.org/view/536582 ER - TY - RPRT AN - 00760734 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT. IN-FLIGHT FIRE/EMERGENCY LANDING FEDERAL EXPRESS FLIGHT 1406 DOUGLAS DC-10-10, N68055 NEWBURGH, NEW YORK SEPTEMBER 5, 1996. ADOPTED: JULY, 1998 NOTATION 6800B PY - 1998/07/22 SP - 137 p. AB - This report explains the accident involving Federal Express flight 1406, a Douglas DC-10-10, which made an emergency landing at Stewart International Airport on September 5, 1996, after the flightcrew determined that there was smoke in the cabin cargo compartment. Safety issues in the report include flightcrew performance of emergency procedures, undeclared hazardous materials in transportation, dissemination of hazardous materials information, airport emergency response, and adequacy of aircraft interior firefighting methods. Safety recommendations concerning these issues were made to the Federal Aviation Administration, the Department of Transportation, and the Research and Special Programs Administration. KW - Air transportation crashes KW - Cargo aircraft KW - Cargo compartments KW - Crash reports KW - Emergencies KW - Fire fighting KW - Flight crews KW - Hazardous materials KW - Hazards and emergency operations KW - Performance evaluations UR - https://trid.trb.org/view/496411 ER - TY - RPRT AN - 00756425 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY STUDY: SAFETY AT PASSIVE GRADE CROSSINGS. VOLUME 1: ANALYSIS PY - 1998/07/21 SP - 136 p. AB - More than 4,000 accidents have occurred at the nation's active and passive grade crossings each year from 1991 through 1996. Many of the accidents at active crossings have involved highway vehicle drivers who did not comply with train-activated warning devices installed at the crossing. Drivers at passive crossing are not provided warnings from train-activated devices; consequently, they must rely on a system of grade crossing signs and pavement markings, passive devices, that are designed to warn drivers only of the presence of a crossing. For this study, the Safety Board investigated 60 grade crossing accidents that have occurred between December 1995 and August 1996. The accidents selected for study involved a collision between a train and a highway vehicle occurring at a passive grade crossing wherein the highway vehicle was sufficiently damaged to require towing. A probable cause was determined for each accident in the study. KW - Grade crossing accidents KW - Grade crossing safety KW - Railroad grade crossings KW - Road markings KW - Safety KW - Traffic crashes KW - Warning devices UR - http://ntl.bts.gov/lib/8000/8400/8412/SS9802.pdf UR - http://ntl.bts.gov/lib/8000/8400/8412/SS9802.pdf UR - https://trid.trb.org/view/537682 ER - TY - RPRT AN - 00756426 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY STUDY: SAFETY AT PASSIVE GRADE CROSSINGS. VOLUME 2: CASE SUMMARIES PY - 1998/07/21 SP - 72 p. AB - More than 4,000 accidents have occurred at the nation's active and passive grade crossings each year from 1991 through 1996. Many of the accidents at active crossings have involved highway vehicle drivers who did not comply with train-activated warning devices installed at the crossings. Drivers at passive crossings are not provided warnings from train-activated devices; they must rely on a system of grade crossing signs and pavement markings, passive devices that are designed to warn drivers only of the presence of a crossing. KW - Crash causes KW - Grade crossing accidents KW - Grade crossing protection systems KW - Grade crossing safety KW - Passive restraint systems KW - Passive systems KW - Railroad grade crossings KW - Safety KW - Traffic crashes UR - http://www.ntsb.gov/safety/safety-studies/Documents/SS9803.pdf UR - http://ntl.bts.gov/lib/8000/8400/8411/SS9803.pdf UR - https://trid.trb.org/view/537683 ER - TY - RPRT AN - 01003107 AU - National Transportation Safety Board TI - Marine Accident Report: Fire Aboard the Tug Scandia and the Subsequent Grounding of the Tug and the Tank Barge North Cape on Moonstone Beach, South Kingston, Rhode Island January 19, 1996 PY - 1998/07/14 SP - 74p AB - On Friday afternoon, January 19, 1996, the U.S. tug Scandia had an engineroom fire while towing the unmanned U.S. tank barge North Cape, 4.5 miles off Point Judith, Rhode Island. All six crewmembers abandoned the Scandia amid 10-foot waves and 25-knot winds; however, no one was injured. The crew was unsuccessful in its attempts to release the anchor of the barge, which ran aground and spilled 828,000 gallons of home heating oil, causing the largest pollution incident in Rhode Island's history, an incident that led to the closing of local fisheries. The National Transportation Safety Board determines that the probable cause of the fire damage aboard the tug Scandia and the subsequent grounding of and pollution from the barge North Cape was the Eklof Marine Corporation's inadequate oversight of maintenance and operations aboard those vessels, which permitted a fire of unknown origin to become catastrophic and eliminated any realistic possibility of arresting the subsequent drift and grounding of the barge. Contributing to the accident was the lack of adequate U.S. Coast Guard and industry standards addressing towing vessel safety. In its investigation, the Safety Board identified the following safety issues: (1) origin and cause of fire; (2)company oversight of vessel maintenance; (3) risk assessment in the areas of weather and voyage planning, barge retrieval systems, anchors on unmanned barges, and fire safety of towing vessels; (4) search and rescue, especially the deployment of Coast Guard rescue boat, hypothermia protective clothing and the decision to return to barge to drop its anchor; and (5) environmental pollution and cleanup. As a result of its investigation of this accident, the Safety Board makes recommendations to the U.S. Coast Guard, the Eklof Marine Corporation, and the American Waterways Operators, Inc. KW - American Waterways Operators KW - Crash causes KW - Crash investigation KW - Crash reports KW - Eklof Marine Corporation KW - Fire causes KW - Groundings (Maritime crashes) KW - Maintenance management KW - Maritime safety KW - Oil spill cleanup KW - Oil spills KW - Oversight KW - Recommendations KW - Rhode Island KW - Risk assessment KW - Search and rescue operations KW - Tank barges KW - Towboat operations KW - Towboats KW - Towed barges KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR9803.pdf UR - https://trid.trb.org/view/759375 ER - TY - RPRT AN - 00805881 AU - National Transportation Safety Board TI - WE ARE ALL SAFER: NATIONAL TRANSPORTATION SAFETY BOARD- (NTSB) INSPIRED IMPROVEMENTS IN TRANSPORTATION SAFETY, SECOND EDITION PY - 1998/07 SP - 75 p. AB - The National Transportation Safety Board (NTSB) was established by Congress in 1967 to investigate and determine the causes of accidents in all modes of transportation. Since then, the Safety Board has investigated more than 110,000 aviation accidents and thousands of railroad, marine, highway, and pipeline accidents. The Board is recognized as one of the world's premier independent accident investigation agencies because of the expertise it has accumulated in more than three decades of experience. On call 24 hours a day, 365 days a year, Safety Board investigators travel to every corner of the world to investigate accidents. The Board's 24-hour communications center coordinates the logistics of accident launches and enables investigators to get to accident sites quickly. The Safety Board also provides assistance to families affected by aviation and other transportation disasters. The Safety Board is responsible for improving and coordinating services to victims' families. At the accident site investigators gather a wide range of information concerning the circumstances of the accident. Investigators and technical experts analyze this information, along with many other factors pertaining to the event, to determine the probable cause of the accident and to develop safety recommendations aimed at preventing similar accidents. The Safety Board has issued 11,000 recommendations in all transportation modes to more than 1,300 recipients in government, industry, and associations. This publication summarizes many of the Safety Board inspired improvements in transportation. KW - Air transportation crashes KW - Aviation safety KW - Boating KW - Crash causes KW - Crash investigation KW - Crash victims KW - Families KW - Ground transportation crashes KW - Highway safety KW - Improvements KW - Marine safety KW - Pipeline safety KW - Pipelines KW - Railroad crashes KW - Railroad safety KW - Recommendations KW - Traffic crashes KW - Transportation safety KW - U.S. National Transportation Safety Board UR - http://ntl.bts.gov/lib/10000/10000/10000/SR9801.pdf UR - https://trid.trb.org/view/672490 ER - TY - RPRT AN - 00753935 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED IMPACT WITH TERRAIN, FINE AIRLINES FLIGHT 101, DOUGLAS DC-8-61, N27UA, MIAMI, FLORIDA, AUGUST 7, 1997 PY - 1998/06/16 SP - 154 p. AB - This report explains the accident involving Fine Airlines flight 101, a Douglas DC-8-61, which crashed after takeoff from runway 27R at Miami International Airport, Miami, Florida, on August 7, 1997. Safety issues in the report include the effects of improper cargo loading on airplane performance and handling, operator oversight of cargo loading and training of cargo loading personnel, the loss of critical flight data recorder information, and Federal Aviation Administration surveillance of cargo carrier operations. KW - Air cargo KW - Air transportation crashes KW - Cargo aircraft KW - Cargo handling KW - Cargo operations KW - Crash investigation KW - Data recorders KW - Loading and unloading KW - Oversight KW - Surveillance KW - Training KW - U.S. Federal Aviation Administration UR - https://trid.trb.org/view/536699 ER - TY - RPRT AN - 00816434 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION AND DERAILMENT OF UNION PACIFIC RAILROAD FREIGHT TRAINS 5981 NORTH AND 9186 SOUTH IN DEVINE, TEXAS, ON JUNE 22, 1997 PY - 1998/05/19 SP - 47 p. AB - On June 22, 1997, Union Pacific Railroad (UP) freight trains 5981 North and 9186 South collided head-on in Devine, Texas. The conductor from 5981 North, the engineer from 9186 South, and two unidentified individuals who may have been riding on 5981 North were killed. The engineer from 5981 North received minor injuries, and the conductor from 9186 South was seriously burned. The major safety issues discussed in this report are the train dispatcher's performance and workload, the adequacy of management oversight of the dispatcher apprentice program and dispatching operations, the sufficiency of the Federal Railroad Administration (FRA) oversight of dispatching operations, the effectiveness of conditional track warrant control authority, the adequacy of disaster preparedness, the crashworthiness of locomotives and event recorders, and the merits of positive train separation control systems. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the UP, the FRA, and the Texas Railroad Commission. In addition, the Safety Board reiterated a safety recommendation to the FRA. KW - Crash investigation KW - Crash reports KW - Crashworthiness KW - Devine (Texas) KW - Disaster preparedness KW - Dispatcher apprentice program KW - Dispatching KW - Event recorders KW - Fatalities KW - Freight trains KW - Frontal crashes KW - Injuries KW - Locomotives KW - Oversight KW - Personnel performance KW - Positive train control KW - Railroad crashes KW - Recommendations KW - Train Dispatcher KW - U.S. Federal Railroad Administration KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9802.pdf UR - https://trid.trb.org/view/690735 ER - TY - RPRT AN - 00816384 AU - National Transportation Safety Board TI - HIGHWAY/HAZARDOUS MATERIALS ACCIDENT SUMMARY REPORT: COLLISION OF TRACTOR/CARGO TANK SEMITRAILER AND PASSENGER VEHICLE AND SUBSEQUENT FIRE, YONKERS, NEW YORK, OCTOBER 9, 1997 PY - 1998/05/05 SP - 27 p. AB - On October 9, 1997, about 12:10 a.m., a truck tractor pulling a cargo tank semitrailer was going under an overpass of the New York State Thruway when it was struck by a sedan. The car hit the right side of the cargo tank in the area of the tank's external loading/unloading lines, releasing the gasoline they contained. The ensuing fire destroyed both vehicles and the overpass; the thruway remained closed for approximately 6 months. The driver of the car was killed; the driver of the truck was not injured. Property damage was estimated at $7 million. The safety issue discussed in this report is the danger of operating a truck when its cargo tank's loading lines are carrying hazardous materials. As a result of its investigation, the National Transportation Safety Board issued a safety recommendation to the Secretary of Transportation. KW - Crash investigation KW - Fire KW - Gasoline KW - Hazardous materials KW - Loading and unloading KW - Recommendations KW - Tankers KW - Yonkers (New York) UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HAR9802S.pdf UR - https://trid.trb.org/view/690695 ER - TY - RPRT AN - 00783669 AU - National Transportation Safety Board TI - SAFETY STUDY: PERSONAL WATERCRAFT SAFETY PY - 1998/05 SP - 104 p. AB - Personal watercraft (PWC) are a type of recreational boat that has become increasingly popular in recent years. Manufacturers estimate that about 200,000 PWC are sold each year and that more than 1 million are in current operation. Although the overall number of recreational boating fatalities has been declining in recent years, the number of personal watercraft-related fatalities has been increasing. PWC are the only type of recreational vessel for which the leading cause of fatalities is not drowning; in PWC fatalities, more persons die from blunt force trauma than from drowning. The National Transportation Safety Board initiated this study to more closely examine fatalities and injury in addition to accident characteristics associated with PWC accidents. The study was not designed to estimate how often PWC accidents occur, nor are the results of the study necessarily representative of all PWC accidents. The Safety Board analyzed 814 (one-third) of the 1997 reported accidents and examined all of the data for the 1996 reported accidents, which the Board believes provided a substantial number of accidents to identify the most important safety issues associated with PWC accidents. The safety issues discussed in the report include (a) protecting PWC riders from injury; (b) PWC operator experience and training; and (c) boating safety standards. The study also addressed the need for recreational boating exposure data. Safety recommendations concerning these issues were made to the manufacturers of PWC, the U.S. Coast Guard Auxiliary, the U.S. Power Squadrons, BOAT/U.S., the National Association of State Boating Law Administrators, the Personal Watercraft Industry Association, and the States and Territories. KW - Boating KW - Crash characteristics KW - Crash data KW - Crash types KW - Fatalities KW - Injuries KW - Operators (Persons) KW - Personal watercraft KW - Recreation KW - Safety KW - Standards KW - Training KW - Water transportation crashes UR - http://ntl.bts.gov/lib/8000/8400/8418/SS9801.pdf UR - http://ntl.bts.gov/lib/8000/8400/8418/SS9801.pdf UR - https://trid.trb.org/view/636808 ER - TY - RPRT AN - 01139254 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Tank Car Failure and Release of Flammable and Toxic Liquid, Sweetwater, Tennessee, February 7, 1996 PY - 1998/04/20 SP - 6p AB - About 5:00 a.m. eastern standard time on February 7, 1996, in Sweetwater, Tennessee, Norfolk Southern eastbound train M34T5 stopped on the main track to allow a westbound train to pull onto a siding. About 5:30 a.m., as the engineer began to move his train forward, an uncommanded emergency brake application occurred. The train had moved about 33 feet and reached a speed of about two mph. When the train conductor walked back to determine the cause of the emergency brake application, he discovered that tank car GATX 92414 had separated almost completely into two halves near the middle of the tank and that about 8,000 gallons of carbon disulfide, a flammable and toxic material, had spilled. As a result of the spill, about 500 people were evacuated from the area, including residents of a nursing home. Five people were seen at a local hospital, but only one person was admitted. The National Transportation Safety Board determines that the probable cause of the failure of tank car GATX 92414 was the installation of discontinuous bottom reinforcement bars, which concentrated stresses on preexisting welding-induced cracks in the middle of the tank. Contributing to the severity of the failure was the brittleness of the tank steel, which promoted the rapid propagation of the overstress fracture and led to an almost complete separation of the tank. KW - Crash causes KW - Crash investigation KW - Hazardous materials KW - Hazardous materials accidents KW - Railroad safety KW - Spills (Pollution) KW - Tank cars KW - Tennessee UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB9802.pdf UR - https://trid.trb.org/view/898608 ER - TY - RPRT AN - 01139225 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Tank Car Structural Failure with the Release and Ignition of Propane, Selkirk, New York, March 6, 1996 PY - 1998/04/20 SP - 4p AB - About 11:40 a.m. eastern standard time on March 6, 1996, tank car UTLX 803627, containing 31,409 gallons of liquefied propane, catastrophically failed about 3 minutes after the tank car had been switched at the Consolidated Rail Corporation (Conrail) classification yard in Selkirk, New York. The propane was released and ignited to create a large fireball. One minor injury was reported; however, there were no fatalities. Damages to freight cars on adjacent tracks and the loss of UTLX 803627 were estimated at about $63,000. Lading losses from the damaged freight cars totaled $256,600. At the time of the accident, the weather was overcast, and the temperature was between 32 and 40 degrees F. The National Transportation Safety Board determines that the probable cause of the failure of tank car UTLX 803627 was a defective weld overlay repair adjacent to the manway that resulted in an overstress fracture near the manway. Contributing to the severity of the failure was the brittleness of the tank steel, which promoted the rapid propagation of the overstress fracture and led to complete separation of the tank. KW - Crash causes KW - Crash investigation KW - Fires KW - Hazardous materials KW - Hazardous materials accidents KW - Propane KW - Railroad safety KW - Structural failures KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB9803.pdf UR - https://trid.trb.org/view/898607 ER - TY - RPRT AN - 01003124 AU - National Transportation Safety Board TI - Marine Accident Report: Fire on Board the Panamanian Passenger Ship Universe Explorer in the Lynn Canal Near Juneau, Alaska, July 27, 1996 PY - 1998/04/14 SP - 84p AB - Early on July 27, 1996, while the Panamanian passenger ship Universe Explorer was en route from Juneau, Alaska, to Glacier Bay, Alaska with 1,006 people aboard, a fire started in the main laundry. Dense smoke and heat spread upward to a deck on which crew quarters were located. Five crewmembers died from smoke inhalation, and 55 crewmembers and 1 passenger sustained minor or serious injuries. One passenger required medical treatment as a result of a pre-existing condition. Sixty-nine people were transported to area hospitals, where 13 of the injured were admitted for further treatment. The estimated damage to the vessel was $1.5 million. The National Transportation Safety Board determines that the probable cause of this accident was a lack of effective oversight by New Commodore Cruise Lines, Ltd., and the predecessor of V. Ships Marine, Ltd. (International Marine Carriers, Inc.), who allowed physical conditions and operating procedures to exist that compromised the fire safety of the Universe Explorer, ultimately resulting in crewmember deaths and injuries from a fire of undetermined origin in the vessel's main laundry. Contributing to the loss of life and injuries was the lack of sprinkler systems, the lack of automatic local-sounding fire alarms, and the rapid spread of smoke through open doors into the crew berthing area. The major safety issues discussed in this report are the adequacy of shipboard communications; the adequacy of fire prevention, detection, and control measures; the adequacy of emergency procedures; and the adequacy of oversight. As a result of its investigation of this accident, the Safety Board makes recommendations to the U.S. Coast Guard, New Commodore Cruise Lines, Ltd., V. Ships Marine, Ltd., the International Council of Cruise Lines, and the American Bureau of Shipping. KW - Alaska KW - American Bureau of Shipping KW - Communications KW - Crash causes KW - Crash investigation KW - Crash reports KW - Cruise ships KW - Disasters and emergency operations KW - Fatalities KW - Fire causes KW - Fire detection systems KW - Fire extinguishers KW - Fires KW - Injuries KW - International Council of Cruise Lines KW - Loss and damage KW - Maritime safety KW - New Commodore Cruise Lines KW - Oversight KW - Passenger ships KW - Recommendations KW - Smoke KW - United States Coast Guard KW - V. Ships Marine, Limited KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR9802.pdf UR - https://trid.trb.org/view/759396 ER - TY - RPRT AN - 01003101 AU - National Transportation Safety Board TI - Marine Accident Brief: Fire Aboard the Passenger Ship Vistafjord, near Grand Bahama Island, Bahamas, April 6, 1997 PY - 1998/03/10 SP - 5p AB - On April 5, the Bahamian-registered passenger ship Vistafjord departed Fort Lauderdale, Florida for a 16-day cruise. On April 6 at about 0112, a fire alarm sounded on the fire control panel in the ship's bridge, indicating a fire in the C-deck laundry storeroom. The passengers and crew were alerted and ordered to report to their lifeboat embarkation area. Nineteen 45-kilogram carbon dioxide bottles were released from a fixed fire extinguishing system into the laundry storeroom and the D-deck storeroom. Crew members and shoreside firefighters worked to control the fire, which was under control and declared extinguished on April 6 at 0700 and 1044, respectively. One crew member died from carbon monoxide poisoning; nine crewmembers and six passengers suffered minor injuries. The National Transportation Safety Board determines that the probable cause of the fire on board the Vistafjord was a deliberate ignition of combustibles at two sites in the laundry storeroom. Contributing to the loss of life was the lack of timely fire warning for the crewmembers in B-deck accommodations and of an automatic sprinkler system in the laundry storeroom. KW - Bahamas KW - Crash causes KW - Crash investigation KW - Crash reports KW - Cruise ships KW - Fire KW - Fire causes KW - Fire extinguishers KW - Maritime safety KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAB9801.pdf UR - https://trid.trb.org/view/759397 ER - TY - RPRT AN - 00753759 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT SUMMARY REPORT: BUS COLLISION WITH PEDESTRIANS, NORMANDY, MISSOURI, JUNE 11, 1997 PY - 1998/02/19 SP - 20 p. AB - On June 11, 1997, a transit bus collided with seven pedestrians at a "park and ride" transit facility in Normandy, Missouri. The bus was being operated by a driver trainee who had just completed a routine stop at the station. After allowing the passengers to debark from the bus, the driver trainee began to move the bus forward to provide clearance for another bus to pass. The driver trainee, who was reportedly unable to stop the bus, allowed it to surmount the curb and continue onto the station platform. The resulting encroachment onto the platform resulted in the deaths of four pedestrians and injuries to three others. The safety issues discussed in this report are the sufficiency of pedestrian protection provided by the saw-tooth parking bay design and the need for positive separation between the roadway and pedestrian areas of parking bay facilities. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Federal Highway Administration, the Federal Transit Administration, the American Association of State Highway and Transportation Officials, the American Public Transit Association, and the Community Transportation Association of America. KW - Bus crashes KW - Bus drivers KW - Fatalities KW - Park and ride KW - Pedestrian protection KW - Pedestrian safety KW - Pedestrian-vehicle crashes UR - http://ntl.bts.gov/lib/9000/9700/9761/HAR9801S.pdf UR - http://ntl.bts.gov/lib/9000/9700/9761/HAR9801S.pdf UR - https://trid.trb.org/view/536583 ER - TY - RPRT AN - 00816433 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: DERAILMENT OF UNION PACIFIC RAILROAD UNIT FREIGHT TRAIN 6205 WEST NEAR KELSO, CALIFORNIA, JANUARY 12, 1997 PY - 1998/02/06 SP - 51 p. AB - On January 12, 1997, the Union Pacific Railroad unit freight train 6205 west derailed on the Union Pacific Los Angeles Subdivision, milepost 238.7, near Kelso, California. While descending Cima Hill, the engineer inadvertently activated the multiple-unit engine shutdown switch, which shut down all the locomotive units' diesel engines and eliminated the units' dynamic braking capabilities. The train rapidly became a runaway, eventually reaching a speed of 72 mph, and derailed 68 of its 75 cars while exiting a siding near Kelso. No fatalities or injuries resulted. The safety issues discussed in this report are the placement of safety-critical locomotive cab controls, adequate train-speed safety margins for steep-grade railroads, and the criticality of dynamic braking systems. The report also discusses accurate car weight reporting, the power brake rulemaking process, and the use of air brake retainers. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Federal Railroad Administration, the Association of American Railroads, and the Union Pacific Railroad. KW - Air brakes KW - Car weight (Railroads) KW - Crash reports KW - Derailments KW - Dynamic braking KW - Engine shutdown switch KW - Freight trains KW - Human error KW - Kelso (California) KW - Locomotive cab controls placement KW - Locomotive engineers KW - Railroad crashes KW - Recommendations KW - Union Pacific Railroad UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9801.pdf UR - https://trid.trb.org/view/690734 ER - TY - RPRT AN - 01139257 AU - National Transportation Safety Board TI - Hazardous Materials Accident Brief: Tank Car Failure and Release of Poisonous and Corrosive Vapors, Gaylord Chemical Corporation, Bogalusa, Louisiana, October 23, 1995 PY - 1998/01/27 SP - 4p AB - At 3:55 p.m. on October 23, 1995, at the Gaylord Chemical Corporation plant in Bogalusa, Louisiana, yellow-brown vapors began leaking from the dome of the DOT class 105A railroad tank car UTLX 82329 that contained a mixture of nitrogen tetroxide, which is a liquefied poisonous gas and oxidizer, and water. The vapors initially formed a plume between 10 and 15 feet in diameter. Plant personnel notified emergency response agencies and used two plant fire hoses to spray water into the plume to suppress the vapors. About 4:30 p.m. Bogalusa fire personnel arrived at the plant and set up fire hoses to help-suppress the vapors. The head on the B-end of the tank car failed about 4:45 p.m., resulting in one end of the tank car jacket being torn away and thrown about 350 feet. The tank car was then propelled 35 feet down the track and derailed at a track bumping block. A large reddish-brown vapor cloud was released from the tank car. Vapors continued to be released from the opening in the tank car for another 36 hours until the chemical reaction that had occurred within the tank was brought under control through neutralization and dilution. Some 3,000 people were evacuated from the area as a result of the vapor cloud. Of 4,710 people who were treated at local hospitals, 81 people were admitted. The National Transportation Safety Board determines that the probable cause of the accident was the lack of adequate procedures on the part of the Gaylord Chemical Corporation and the Vicksburg Chemical Company to prevent or detect the contamination of nitrogen tetroxide with water, resulting in the formation of an extremely corrosive product and the subsequent failure of the tank car. Contributing to the severity of the accident were the Gaylord Chemical Corporation’s inadequate procedures for emergency transfer of contaminated cargo from the tank car. KW - Crash causes KW - Crash investigation KW - Failure KW - Hazardous materials KW - Hazardous materials accidents KW - Louisiana KW - Poisonous gases KW - Railroad safety KW - Tank cars UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/HZB9801.pdf UR - https://trid.trb.org/view/898619 ER - TY - RPRT AN - 01003095 AU - National Transportation Safety Board TI - Marine Accident Report: Allision of the Liberian Freighter Bright Field with the Poydras Street Wharf, Riverwalk Marketplace and New Orleans Hilton Hotel in New Orleans, Louisiana, December 14, 1996 PY - 1998/01/13 SP - 99p AB - On December 14, 1996, the fully loaded Liberian bulk carrier Bright Field temporarily lost propulsion power as the vessel was navigating outbound in the Lower Mississippi River at New Orleans, Louisiana. The vessel struck a wharf adjacent to a populated commercial area that included a shopping mall, a condominium parking garage, and a hotel. No fatalities resulted from the accident, and no one aboard the Bright Field was injured; however, 4 serious injuries and 58 minor injuries were sustained during evacuations of shore facilities, a gaming vessel, and an excursion vessel located near the impact area. Total property damages to the Bright Field and to shoreside facilities were estimated at about $20 million. The safety issues discussed in this report are the adequacy of the ship’s main engine and automation systems, the adequacy of emergency preparedness and evacuation plans of vessels moored in the Poydras Street wharf area, and the adequacy of port risk assessment for activities within the Port of New Orleans. This report also addresses three other issues: the actions of the pilot and crew during the emergency, the lack of effective communication (as it relates to the actions of the pilot and crew aboard the Bright Field on the day of the accident), and the delay in administering toxicological tests to the vessel crew. As a result of its investigation, the National Transportation Safety Board issued recommendations to the U.S. Coast Guard, the U.S. Army Corps of Engineers, the State of Louisiana, the Board of Commissioners of the Port of New Orleans, International RiverCenter, Clearsky Shipping Company, New Orleans Paddlewheels, Inc., the New Orleans Baton Rouge Steamship Pilots Association, the Crescent River Port Pilots Association, and Associated Federal Pilots and Docking Masters of Louisiana, Inc. KW - Allisions KW - Bulk carriers KW - Communication KW - Crash causes KW - Crash investigation KW - Crash reports KW - Disasters and emergency operations KW - Evacuation KW - Injuries KW - Loss and damage KW - Maritime safety KW - New Orleans (Louisiana) KW - Port structures KW - Recommendations KW - Water transportation crashes KW - Wharves UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR9801.pdf UR - https://trid.trb.org/view/759412 ER - TY - RPRT AN - 00748790 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTAINED ENGINE FAILURE, DELTA AIR LINES FLIGHT 1288, MCDONNELL DOUGLAS MD-88, N927DA, PENSACOLA, FLORIDA, JULY 6, 1996 PY - 1998/01/13 SP - 135 p. AB - This report explains the accident involving Delta Air Lines flight 1288, an MD-88, which experienced an uncontained engine failure during the initial part of its takeoff roll at Pensacola Regional Airport in Pensacola, Florida, on July 6, 1996. Two passengers were killed and two others were seriously injured. Safety issues in the report include the limitations of the blue etch anodize process, manufacturing defects, standards for the fluorescent penetrant inspection process, the performance of nondestructive testing, the use of alarm systems for emergency situations, and instructions regarding emergency exits. Safety recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Alarm systems KW - Defects KW - Emergency exits KW - Engine failures KW - Engine inspection KW - Engines KW - Fatalities KW - Injuries KW - Inspection KW - Instructions KW - Mechanical failure KW - Nondestructive tests UR - https://trid.trb.org/view/483814 ER - TY - RPRT AN - 01010914 AU - National Transportation Safety Board TI - Special Investigation Report: Brittle-Like Cracking in Plastic Pipe for Gas Service PY - 1998 SP - 55p AB - Despite the general acceptance of plastic piping as a safe and economical alternative to piping made of steel or other materials, the National Transportation Safety Board notes that a number of pipeline accidents it has investigated have involved plastic piping that cracked in a brittle-like manner. This special investigation report concludes that the procedure used in the United States to rate the strength of plastic pipe may have overrated the strength and resistance to brittle-like cracking of much of the plastic pipe manufactured and used for gas service from the 1960s through the early 1980s. As a result, much of this piping may be susceptible to premature brittle-like failures when subjected to stress intensification, and these failures represent a potential public safety hazard. The safety issues discussed in this report are the vulnerability of plastic piping to premature failures due to brittle-like cracking; the adequacy of available guidance relating to the installation and protection of plastic piping connections to steel mains; and performance monitoring of plastic pipeline systems as a way of detecting unacceptable performance in piping systems. As a result of this special investigation, the National Transportation Safety Board issued recommendations to the Research and Special Programs Administration, the Gas Research Institute, the Plastics Pipe Institute, the Gas Piping Technology Committee, the American Society for Testing and Materials, the American Gas Association, MidAmerican Energy Corporation, Continental Industries, Inc., Dresser Industries, Inc., Inner-Tite Corporation, and Mueller Company. KW - Brittleness KW - Cracking KW - Gas pipelines KW - Installation KW - Monitoring KW - Performance KW - Pipeline safety KW - Plastic pipe KW - Recommendations KW - Steel pipe KW - Structural connection UR - http://www.ntsb.gov/safety/safety-studies/Documents/SIR9801.pdf UR - https://trid.trb.org/view/767309 ER - TY - RPRT AN - 00899318 AU - National Transportation Safety Board AU - RAILROAD ACCIDENT REPORT; TI - DERAILMENT OF AMTRAK TRAIN 4, SOUTHWEST CHIEF, ON THE BURLINGTON NORTHERN SANTA FE RAILWAY NEAR KINGMAN, ARIZONA, AUGUST 9, 1997. T2 - DERAILMENT OF AMTRAK TRAIN FOUR, SOUTHWEST CHIEF, ON THE BURLINGTON NORTHERN SANTA FE RAILWAY NEAR KINGMAN, ARIZONA, AUGUST 9, 1997 PY - 1998 IS - NTSB/AR-98/03 AB - No abstract provided. KW - Bridges KW - Kingman KW - Railroad bridges KW - Railroad crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9803.pdf UR - https://trid.trb.org/view/612897 ER - TY - CONF AN - 00789173 AU - Rosekind, M R AU - American Trucking Associations TI - ALERTNESS MANAGEMENT: STRATEGIC NAPS IN OPERATIONAL SETTINGS SN - 0865875162 PY - 1998 SP - p. 123-131 AB - Strategic naps can be used effectively to promote performance and alertness in operational settings. A study of planned rest periods in long-haul flight operations has demonstrated the effectiveness of in-flight naps to promote performance and alertness during subsequent critical phases of flight. Two potential negative effects of naps are discussed. These are sleep inertia and the effect of naps on subsequent sleep. Sleep inertia can involve sleepiness and decreased performance immediately upon awakening from a nap. A long nap, at certain times of the day, can disrupt the quantity and quality of later sleep periods. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Alertness KW - Fatigue (Physiological condition) KW - Flight KW - Management KW - Naps KW - Performance KW - Sleep KW - Sleep deprivation KW - Transportation operations UR - https://trid.trb.org/view/650801 ER - TY - CONF AN - 00789175 AU - HALL, J AU - American Trucking Associations TI - ROLE OF THE NATIONAL TRANSPORTATION SAFETY BOARD SN - 0865875162 PY - 1998 SP - p. 137-143 AB - As an independent agency, the National Transportation Safety Board (NTSB) is charged by Congress with two major tasks: to determine the probable causes of all major transportation accidents, and to issue safety recommendations aimed at preventing accidents. In its 30 year history, the Safety Board has issued over 80 recommendations related to fatigue in all the modes of transportation. Although it is the ultimate duty of any transportation provider to ensure all persons having a safety sensitive position be fit to perform - and that includes not being fatigued - the U.S. Department of Transportation has the ultimate responsibility through its oversight and regulation to make it so. The NTSB fears that to date, DOT's record has been spotty in this area. This paper discusses the positive actions that the DOT has taken to ensure that fatigue be addressed by operators in all modes of transportation, and also the areas in which they fall short. The author also notes that it is incumbent on transportation companies not to provide the wrong signals to its employees with respect to safety. He discusses the distinct markers that can indicate a potentially unsafe corporate culture, which gives the wrong signals to its employees with respect to safety. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Corporations KW - Crash causes KW - Crashes KW - Culture (Social sciences) KW - Fatigue (Physiological condition) KW - Human factors KW - Prevention KW - Recommendations KW - Safety KW - Sleep deprivation KW - Traffic safety KW - Transportation modes KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/650803 ER - TY - CONF AN - 00789171 AU - Belenky, G AU - American Trucking Associations TI - SUSTAINING PERFORMANCE DURING CONTINUOUS OPERATIONS: THE U.S. ARMY'S SLEEP MANAGEMENT SYSTEM SN - 0865875162 PY - 1998 SP - p. 95-103 AB - The U.S. Army is developing a field-deployable sleep management system to maximize individual and unit performance during continuous operation. The sleep management system is an unobtrusive, wrist-worn, wrist-watch sized device containing hardware and software to: measure sleep in individual soldiers under operational conditions; 2) predict performance as a function of the sleep so measured; and 3) monitor alertness and performance in real-time. The author discusses research on the effect of sleep deprivation on human performance and gives an example of how the sleep management system would be used in a real combat situation. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Alertness KW - Computers KW - Human beings KW - Measurement KW - Military personnel KW - Monitoring KW - Performance KW - Real time information KW - Research KW - Sleep KW - Sleep deprivation KW - Software KW - United States Army UR - https://trid.trb.org/view/650799 ER - TY - CONF AN - 00789176 AU - Mahon, G L AU - American Trucking Associations TI - NEW APPROACHES TO FATIGUE MANAGEMENT: A REGULATOR'S PERSPECTIVE SN - 0865875162 PY - 1998 SP - p. 145-153 AB - The Fatigue Management Program is an initiative by the Queensland Department of Transport to move toward performance-based legislation to manage a major occupational hazard - fatigue - in the road transport industry. The program targets the development and implementation of management training, schedules, and education programs that focus on fatigue and outlines the need for drivers to acquire amounts of quality sleep, develop strategies for avoiding sleep loss, and consider the behavioral and physiological consequences of tiredness. This will enhance awareness that sleep can occur suddenly and without warning to all drivers regardless of their age or experience and that fatigue has a serious effect on a driver's work performance and safety. Successful management of driver fatigue involves a cooperative approach between management and their drivers. It is about balancing the fatigue levels of each driver and providing the appropriate countermeasures to alleviate the impact or onset of fatigue. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Australia KW - Drowsiness KW - Education KW - Fatigue (Physiological condition) KW - Freight transportation KW - Legislation KW - Management KW - Performance KW - Schedules KW - Sleep KW - Sleep deprivation KW - Strategic planning KW - Traffic crashes KW - Traffic safety KW - Truck crashes KW - Truck drivers KW - Trucking safety UR - https://trid.trb.org/view/650804 ER - TY - CONF AN - 00789174 AU - Hitchcock, R J AU - American Trucking Associations TI - MONITORING OPERATOR ALERTNESS SN - 0865875162 PY - 1998 SP - p. 133-136 AB - The loss of alertness or drowsiness on the roadway constitutes a significant health problem in America. Statistically, loss of alertness or drowsy driving on the highways has been identified as a contributing factor in only about 1.6% of all motor vehicle crashes per year. That 1.6% translates into about 100,000 crashes per year, including 1,500 fatalities. However, the National Highway Traffic Safety Administration (NHTSA) believes these occurrences to be under reported. In general, and for a number of reasons, many drowsy drivers go undetected. NHTSA has two major drowsiness-related activities. The first one is education based and involves a public information campaign on the role of fatigue in highway crashes. The second activity relates to technology. A drowsy driver technology program is underway to develop, test, and evaluate a drowsiness detection and warning system for commercial motor vehicle drivers. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Alertness KW - Commercial vehicles KW - Countermeasures KW - Detectors KW - Fatalities KW - Fatigue (Physiological condition) KW - Public information programs KW - Sleep deprivation KW - Technology KW - Traffic crashes KW - Truck drivers KW - U.S. National Highway Traffic Safety Administration KW - Warning devices UR - https://trid.trb.org/view/650802 ER - TY - CONF AN - 00789170 AU - Sweet, D A AU - American Trucking Associations TI - REGULATION VS. MANAGEMENT OF FATIGUE: AN INTERNATIONAL PERSPECTIVE ON MANAGING FATIGUE IN TRANSPORTATION SN - 0865875162 PY - 1998 SP - p. 87-92 AB - The volume of business done between Canada and the U.S. shows quite dramatically that Canada is by far the largest trading partner of the United States. Nearly 60% of Canada's exports to the U.S, and 80% of Canada's imports, move by truck. Clearly, trucking is by far the predominant mode of transport between the two countries. This paper discusses "regulation vs management" of fatigue in the trucking industry. Canada has a rich history of regulation. However, this is changing. The paper includes discussions of the "management" alternative in principle and the "management" alternative in practice. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Canada KW - Fatigue (Physiological condition) KW - Management KW - Regulations KW - Truck drivers KW - Trucking KW - United States UR - https://trid.trb.org/view/650798 ER - TY - CONF AN - 00789172 AU - Akerstedt, T AU - American Trucking Associations TI - READILY AVAILABLE COUNTERMEASURES AGAINST OPERATOR FATIGUE SN - 0865875162 PY - 1998 SP - p. 105-122 AB - Irregular work hours will cause severe sleepiness and increased risks of accidents, particularly in relation to night work. The optimum strategy for reducing sleepiness in connection with irregular work hours would be to simple avoid night and early morning work and to ensure proper time for sleep between work periods. Still, if irregular work hours cannot be avoided, fatigue may be reduced through strategic sleeping (including naps), coffee intake, and phase adjustment through light or melatonin (not properly evaluated yet, though). As a complement, alertness may be protected through increasing the level of stimulation in the work situation. This may be accomplished through changing work tasks, controlled noise, light physical activity or interaction with work mates. To some extent also cold air, fresh air, and bright light may be effective. However, it should be emphasized that increased stimulation is effective only for as long as the stimulation is applied. The effect wears off very rapidly. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Alertness KW - Caffeine KW - Circadian rhythms KW - Coffee KW - Cold air KW - Countermeasures KW - Fatigue (Physiological condition) KW - Fresh air KW - Hours of labor KW - Light KW - Melatonin KW - Morning KW - Naps KW - Night shifts KW - Sleep KW - Sleep deprivation KW - Stimulation UR - https://trid.trb.org/view/650800 ER - TY - CONF AN - 00789168 AU - Comstock, M L AU - American Trucking Associations TI - ALERTNESS IN THE RAILROAD INDUSTRY SN - 0865875162 PY - 1998 SP - p. 29-38 AB - The purpose of this paper is to describe the process that Consolidated Rail Corporation is using to incorporate science into the operating practice demands of the railroad industry, in order to help employees reduce job-related fatigue and improve their overall health and safety. Topics covered include fatigue risk factors, operational evaluation, fatigue measurement techniques, fatigue countermeasures, countermeasure evaluation and critical success factors. Specific fatigue countermeasures discussed include training, sleep disorders screening, improved information flow, terminal resting facilities, on train napping policy, communication headsets, and work/rest improvements. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Alertness KW - Communications KW - Countermeasures KW - Employees KW - Fatigue (Physiological condition) KW - Headsets KW - Information dissemination KW - Measurement KW - On train napping KW - Operators (Persons) KW - Railroad terminals KW - Railroads KW - Rest periods KW - Risk analysis KW - Sleep disorders KW - Training UR - https://trid.trb.org/view/650796 ER - TY - CONF AN - 00789167 AU - Hartley, L R AU - American Trucking Associations TI - BEYOND ONE SIZE FITS ALL HOURS OF SERVICE REGULATIONS SN - 0865875162 PY - 1998 SP - p. 9-27 AB - Increasing attention, both nationally and internationally, is being paid to the management of fatigue among all classes of drivers but especially among truck and bus drivers. This paper is divided into two parts. The first part describes research into the question of whether the introduction of driving and related working hours regulations to Western Australia (WA) would be beneficial. To do so, research considered the impact of the proposed regulations on the WA industry; the success of enforcing the regulations in other states; the impact of fatigue on drivers in WA versus the states regulating driving hours; and the effectiveness of self regulation in WA as compared to enforcement in other states. It was concluded that there is no evidence that the introduction of prescriptive driving hours into WA would benefit the community, and quite possibly might worsen the problem of fatigue. The second part of the paper describes the WA Government response to the research. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Bus drivers KW - Fatigue (Physiological condition) KW - Governments KW - Hours of labor KW - Regulations KW - Research KW - Truck drivers KW - Western Australia UR - https://trid.trb.org/view/650795 ER - TY - CONF AN - 00789169 AU - American Trucking Associations TI - THE PROMISE AND CHALLENGES OF TECHNOLOGIES FOR MONITORING OPERATOR VIGILANCE SN - 0865875162 PY - 1998 SP - p. 77-86 AB - This article presents some of the major issues regarding the challenges of identifying, developing, and setting standards for the burgeoning initiatives in technological approaches to operator vigilance and fatigue management in transportation. Operator vigilance technologies offer one of a number of ways to optimize safety through prevention of fatigue-related catastrophes, while permitting greater flexibility in work-rest scheduling to facilitate economic and related pragmatic goals, as well as personal choices. However, in order to determine whether this goal is achievable, information and standards are needed for determining the effectiveness of any given technological approach. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Fatigue (Physiological condition) KW - Human factors KW - Management KW - Operators (Persons) KW - Rest periods KW - Safety KW - Standards KW - Technology KW - Vigilance KW - Working conditions UR - https://trid.trb.org/view/650797 ER - TY - CONF AN - 00789166 AU - American Trucking Associations TI - MANAGING FATIGUE IN TRANSPORTATION, APRIL 29-30, 1997, TAMPA, FLORIDA. INTERNATIONAL CONFERENCE PROCEEDINGS SN - 0865875162 PY - 1998 SP - 206p AB - This international conference was convened because the increasing weight of research evidence, as well as recent technological developments, convinced multi-modal leaders that the time was ripe to collectively address the ability of current regulations and operational procedures to counteract fatigue in all transportation operations. The focus of the conference - managing operator fatigue - attracted leading scientists, government officials, and transportation managers from around the world, and was widely praised for the quality of the speakers and the message they delivered: the need for regulatory flexibility to allow transportation companies and operators to responsibly manage their fatigue risks based on the most current research findings. To identify common operator fatigue issues across transportation modes, world-renowned sleep researchers who specialize in sleep loss, fatigue, and sustained operator performance, gave in-depth presentations of scientific findings that contributed practical information on a diversity of topics pertinent to fatigue management. U1 - Managing Fatigue in TransportationAmerican Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety BoardTampa, Florida StartDate:19970429 EndDate:19970430 Sponsors:American Trucking Associations, Association of American Railroads, Federal Highway Administration, Federal Railroad Administration, National Highway Traffic Safety Administration, and National Transportation Safety Board KW - Alertness KW - Conferences KW - Fatigue (Physiological condition) KW - Management KW - Multimodal transportation KW - Operators (Persons) KW - Performance KW - Regulations KW - Research KW - Researchers KW - Risk management KW - Sleep deprivation KW - Sustained operator performance KW - Traffic safety UR - https://trid.trb.org/view/650794 ER - TY - RPRT AN - 00888785 AU - National Transportation Safety Board TI - PIPELINE ACCIDENT REPORT: PIPELINE RUPTURE AND RELEASE OF FUEL OIL INTO THE REEDY RIVER AT FORK SHOALS, SOUTH CAROLINA, JUNE 26, 1996. PY - 1998 IS - PB98-916502 AB - No abstract provided. KW - Crashes KW - Fork shoals KW - Pipelines UR - https://trid.trb.org/view/579725 ER - TY - RPRT AN - 00888784 AU - National Transportation Safety Board TI - PIPELINE ACCIDENT/INCIDENT REPORT: PIPELINE RUPTURE, LIQUID BUTANE RELEASE AND FIRE, LIVELY, TEXAS, AUGUST 24, 1996. PY - 1998 IS - PB98-916503 AB - No abstract provided. KW - Butane KW - Crashes KW - Lively KW - Pipelines UR - https://trid.trb.org/view/579724 ER - TY - RPRT AN - 00886352 AU - National Transportation Safety Board TI - POST ACCIDENT TESTING FOR ALCOHOL AND OTHER DRUGS IN THE MARINE INDUSTRY AND THE RAMMING OF THE PORTLAND-SOUTH PORTLAND (MILLION DOLLAR) BRIDGE AT PORTLAND, MAINE, BY THE LIBERIAN TANKSHIP JULIE N ON SEPTEMBER 27, 1996 SPECIAL INVESTIGATION REPORT. PY - 1998 IS - NTSB/SIR-98/02 AB - No abstract provided. KW - Bridges KW - Marine safety KW - Portland (Maine) KW - Water transportation crashes UR - http://ntl.bts.gov/lib/8000/8400/8419/SIR9802.pdf UR - http://ntl.bts.gov/lib/8000/8400/8419/SIR9802.pdf UR - https://trid.trb.org/view/579143 ER - TY - RPRT AN - 00744957 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT/INCIDENT SUMMARY REPORT: COLLISION WITH A PEDESTRIAN BY A UTILITY TRUCK NEAR COSMOPOLIS, WASHINGTON, NOVEMBER 26, 1996 PY - 1997/10/17 SP - 12 p. AB - On November 26, 1996, a utility truck collided with and fatally injured a 10-year-old student near Cosmopolis, Washington. The child had just exited a transit bus that had transported him from school to his residence. No other injuries were involved. The major safety issues discussed in this report are the inequity between the safety of children transported on school buses and the safety of children transported on transit buses and the lack of mechanism in place to document and define the safety risks of pupil transportation by transit buses. As a result of its investigation, the Safety Board issued recommendations to the U.S. Department of Transportation, the National Association of State Directors of Pupil Transportation Services, the American Public Transit Association, and the Community Transportation Association of America. KW - Bus crashes KW - Child safety KW - Children KW - Pedestrian-vehicle crashes KW - Pedestrians KW - Safety KW - School buses KW - School children KW - School safety KW - Traffic safety UR - http://ntl.bts.gov/lib/9000/9700/9763/HAR9701S.pdf UR - http://ntl.bts.gov/lib/9000/9700/9763/HAR9701S.pdf UR - https://trid.trb.org/view/472354 ER - TY - RPRT AN - 00744956 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT SUMMARY REPORT: TRUCK LOSS OF BRAKING CONTROL ON STEEP DOWNGRADE AND COLLISION WITH A VEHICLE NEAR PLYMOUTH MEETING, PENNSYLVANIA ON APRIL 25, 1996 PY - 1997/10/17 SP - 19 p. AB - On April 25, 1996, a truck with a concrete mixer body, unable to stop, proceeded through an intersection and collided with and overrode a passenger car near Plymouth Meeting, Pennsylvania. The driver of the car was fatally injured, and the truckdriver sustained minor injuries. The major safety issues discussed in this report are the maintenance and truck inspection practices of JDM Materials Company, Inc., and the adequacy of Federal and State guidelines for conducting truck air brake system inspections. As a result of its investigation, the Safety Board issued recommendations to the Federal Highway Administration; the Commercial Vehicle Safety Alliance; the American Trucking Associations, Inc.; the National Ready Mix Concrete Association; the JDM Materials Company, Inc.; the Pennsylvania Department of Transportation; the Truck Manufacturers Association; the National Highway Traffic Safety Administration; and the Society of Automotive Engineers. KW - Air brakes KW - Brakes KW - Braking performance KW - Inspection KW - Motor vehicles KW - Truck brakes KW - Truck crashes KW - Trucks KW - Vehicle maintenance UR - http://ntl.bts.gov/lib/9000/9700/9762/HAR9702S.pdf UR - http://ntl.bts.gov/lib/9000/9700/9762/HAR9702S.pdf UR - https://trid.trb.org/view/472353 ER - TY - RPRT AN - 00744962 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: DESCENT BELOW VISUAL GLIDEPATH AND COLLISION WITH TERRAIN, DELTA AIR LINES FLIGHT 554, MCDONNELL DOUGLAS MD-88, N914DL, LAGUARDIA AIRPORT, NEW YORK, OCTOBER 19, 1996 PY - 1997/08/25 SP - 170 p. AB - This report explains the descent below visual glidepath and collision with terrain of Delta Air Lines flight 554 at LaGuardia Airport on October 19, 1996. The safety issues in this report focused on the possible hazards of monovision contact lenses, visual illusions encountered during the approach, non-instantaneous vertical speed information, the weather conditions encountered during the approach, the guidance in air carrier's manuals regarding flightcrew member duties, the stabilized approach criteria in air carrier's manuals, emergency evacuation procedures, special airport criteria and designation, and LaGuardia Airport issues/runway light spacing. Safety recommendations concerning these issues were addressed to the Federal Aviation Administration and to optometric associations. KW - Air transportation crashes KW - Airport runways KW - Approach control KW - Contact lenses KW - Crash investigation KW - Delta Air Lines KW - Descent KW - Flight crews KW - LaGuardia Airport KW - Vision KW - Visual acuity UR - https://trid.trb.org/view/472359 ER - TY - RPRT AN - 00744960 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT FIRE AND IMPACT WITH TERRAIN, VALUJET AIRLINES, FLIGHT 592, DC-9-32, N904VJ, EVERGLADES, NEAR MIAMI, FLORIDA, MAY 11, 1996 PY - 1997/08/19 SP - 257 p. AB - This report explains the in-flight fire and impact with terrain of ValuJet Airlines flight 592, a DC-9-32, N904VJ, in the Everglades near Miami, Florida, on May 11, 1996. Safety issues discussed in the report include minimization of the hazards posed by fires in class D cargo compartments; equipment, training, and procedures for addressing in-flight smoke and fire aboard air carrier airplanes; guidance for handling of chemical oxygen generators and other hazardous aircraft components; SabreTech's and ValuJet's procedures for handling company materials and hazardous materials; ValuJet's oversight of its contract heavy maintenance facilities; the Federal Aviation Administration's oversight of ValuJet and ValuJet's contract maintenance facilities; FAA's and the Research and Special Programs Administration's (RSPA) hazardous materials program and undeclared hazardous materials in the U.S. mail; and ValuJet's procedures for boarding and accounting for lap children. Safety recommendations concerning these issues were made to the FAA, RSPA, the U.S. Postal Service, and the Air Transport Association. KW - Air transportation KW - Air transportation crashes KW - Air travel KW - Airlines KW - Cargo handling KW - Crash investigation KW - Hazardous materials KW - Hazardous materials transportation KW - Oxygen equipment KW - Passenger service KW - Transportation UR - https://trid.trb.org/view/472357 ER - TY - RPRT AN - 00744961 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED FLIGHT INTO TERRAIN, ABX AIR (AIRBORNE EXPRESS), DOUGLAS DC-8-63, N827AX, NARROWS, VIRGINIA, DECEMBER 22, 1996 PY - 1997/07/15 SP - 107 p. AB - This report explains the accident involving a Douglas DC-8-63, operated by ABX Air Inc. (Airborne Express), that impacted mountainous terrain near Narrows, Virginia, while on a post-modification functional evaluation flight on December 22, 1996. Safety issues in the report include airplane stall recovery procedures for functional evaluation flights, stall warning systems, fidelity of the ABX DC-8 flight training simulator, guidelines and limitations for conducting functional evaluation flights, and Federal Aviation Administration surveillance of air carrier functional evaluation flight programs. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Airlines KW - Aviation safety KW - Crash investigation KW - Flight training KW - U.S. Federal Aviation Administration KW - Virginia UR - http://ntl.bts.gov/lib/1000/1100/1153/956.pdf UR - https://trid.trb.org/view/472358 ER - TY - RPRT AN - 00744963 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY COLLISION UNITED EXPRESS FLIGHT 5925 AND BEECHCRAFT KING AIR A90, QUINCY MUNICIPAL AIRPORT, QUINCY, ILLINOIS, NOVEMBER 19, 1996 PY - 1997/07/01 SP - 88 p. AB - This report explains the accident involving United Express flight 5925, a Beechcraft 1900C, and a Beechcraft King Air A90 that collided at the intersection of runway 13 and runway 04 at Quincy Municipal Airport, near Quincy, Illinois, on November 19, 1996. Safety issues in the report include the importance of emphasizing careful scanning techniques during flight training, Beech 1900C certification standards and compliance with requirements on door jamming, the certification of small airports used by scheduled commuter airlines, and aircraft rescue and fire fighting protection on scheduled commuter aircraft having 10 seats or more. Safety recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Aircraft KW - Aircraft fires KW - Beech aircraft KW - Commuter airlines KW - Crash investigation KW - Fires KW - Flight training KW - Small aircraft UR - https://trid.trb.org/view/472360 ER - TY - RPRT AN - 01003086 AU - National Transportation Safety Board TI - Marine Accident Report: Grounding of the Liberian Passenger Ship Star Princess on Poundstone Rock, Lynn Canal, Alaska, June 23, 1995 PY - 1997/06/20 SP - 71p AB - On June 23, 1995, the passenger vessel Star Princess, traveling from Skagway to Juneau, Alaska, grounded on Poundstone Rock in Lynn Canal, about 21 miles northwest of Juneau. The vessel's bottom sustained significant damage. No injuries or deaths resulted from this accident. The total cost resulting from required repairs and the delay before the vessel could return to service was estimated at $27.16 million. The major safety issues discussed in this report are the adequacy of the pilot's physical fitness for duty, the importance of bridge resource management, the pilotage practices in the Alaskan cruise industry, and the need for search and rescue planning. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the U.S. Coast Guard, the State pilot commissions, the Alaska Board of Marine Pilots, the Southeastern Alaska Pilots Association, the Alaska Coastwise Pilot Association, the San Diego Bay Pilots Association, Inc., Princess Cruise Lines, the American Pilots' Association, and the International Council of Cruise Lines. KW - Alaska KW - Bridge resource management KW - Crash causes KW - Crash investigation KW - Crash reports KW - Cruise lines KW - Diseases and medical conditions KW - Groundings (Maritime crashes) KW - Loss and damage KW - Lynn Canal KW - Maritime safety KW - Passenger ships KW - Recommendations KW - Search and rescue operations KW - Ship pilotage KW - Ship pilots KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR9702.pdf UR - https://trid.trb.org/view/759445 ER - TY - RPRT AN - 01003109 AU - National Transportation Safety Board TI - Marine Accident Report: Grounding of the Panamanian Passenger Ship Royal Majesty on Rose and Crown Shoal near Nantucket, Massachusetts, June 10, 1995 PY - 1997/04/02 SP - 75p AB - On June 10, 1995, the Panamanian passenger ship Royal Majesty grounded on Rose and Crown Shoal about 10 miles east of Nantucket Island, Massachusetts, and about 17 miles from where the watch officers thought the vessel was. The vessel, with 1,509 persons aboard, was en route from St. George's Bermuda, to Boston, Massachusetts. There were no deaths or injuries as a result of this accident. Damage to the vessel and lost revenue, however, were estimated at about $7 million. This report examines the following major safety issues: performance of the Royal Majesty's integrated bridge system and the global positioning system, performance of the Royal Majesty's watch officers, effects of automation on watch officers' performance, training standards for watch officers aboard vessels equipped with electronic navigation systems and integrated bridge systems, and design, installation, and testing standards for integrated bridge systems. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to Majesty Cruise Line, the U.S. Coast Guard, STN Atlas Elektronik GmbH, Raytheon Marine, the National Marine Electronics Association, the International Electrotechnical Commission, the International Council of Cruise Lines, the International Chamber of Shipping, and the International Association of Independent Tanker Owners. KW - Automation KW - Crash causes KW - Crash investigation KW - Crash reports KW - Groundings (Maritime crashes) KW - Loss and damage KW - Maritime safety KW - Nantucket Island (Massachusetts) KW - Passenger ships KW - Recommendations KW - Ship navigational aids KW - Training KW - Watchkeeping KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/mar9701.pdf UR - https://trid.trb.org/view/759459 ER - TY - RPRT AN - 00816432 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: NEAR HEAD-ON COLLISION AND DERAILMENT OF TWO NEW JERSEY TRANSIT COMMUTER TRAINS NEAR SECAUCUS, NEW JERSEY, FEBRUARY 9, 1996 PY - 1997/03/25 SP - 46 p. AB - This report explains the collision of two New Jersey Transit trains near Secaucus, New Jersey, on February 9, 1996. Three people were killed and 69 people were treated at area hospitals for minor to serious injuries sustained in this accident. The total estimated damage exceeded $3.3 million. From its investigation of this accident, the National Transportation Safety Board identified the following safety issues: The medical condition of the engineer of train 1254, the adequacy of medical standards for locomotive engineers, and the adequacy of the response to the accident by New Jersey Transit train crewmembers. Based on its findings, the Safety Board made recommendations to the Federal Railroad Administration, the New Jersey Transit, the Association of American Railroads, the American Public Transit Association, the Brotherhood of Locomotive Engineers, and the United Transportation Union. KW - Crash investigation KW - Crash reports KW - Crew emergency response KW - Diseases and medical conditions KW - Fatalities KW - Frontal crashes KW - Injuries KW - Locomotive engineers KW - Loss and damage KW - Medical standards KW - Rail transit KW - Railroad commuter service KW - Railroad crashes KW - Recommendations KW - Secaucus (New Jersey) KW - Train crews UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9701.pdf UR - https://trid.trb.org/view/690733 ER - TY - RPRT AN - 00740745 AU - National Transportation Safety Board AU - Harvard University TI - THE AIRBAG'S TEFLON IMAGE: A NATIONAL SURVEY OF KNOWLEDGE AND ATTITUDES PY - 1997/03/17 SP - 25 p. AB - The Centers for Risk Analysis and Injury Control of the Harvard School of Public Health sponsored a representative survey of 1,000 randomly-sampled Americans regarding their knowledge, perceptions, and attitudes about airbags and passenger safety. The key findings of the survey are summarized as follows: KNOWLEDGE: 67.1% of respondents recognize that it is dangerous to place an infant in a rear-facing restraint in the front seat of a vehicle with a passenger-side airbag; 71.0% of respondents recognize that a driver can be seriously injured or killed by an airbag if the driver is seated too close to the steering wheel; 68.4% of respondents recognize that more lives of female drivers have been saved by airbags than have been killed by airbags; MISPERCEPTIONS: 59.9% of respondents are under the (mistaken) impression that the lives of more children have been saved by airbags than have been killed by airbags; when asked when it becomes safe for a child to sit in the front seat, fewer than 25% of respondents with children in the home picked age 12 or greater, even though safety experts recommend that children under age 12 sit in the rear seat; 77.8% of respondents are under the (mistaken) impression that the risk of airbag-induced injury is minimal if a driver wears a seatbelt properly; 51.3% of respondents are not aware that a majority of the lives that have been saved by airbags have been among people who were not wearing seatbelts; 74.0% of respondents are not aware that the deployment threshold for airbags has been set by manufacturers at a level equivalent to hitting a cement wall at 12 mph (19.3 kph); ATTITUDES: 70.9% of respondents would favor a law in their state requiring children under the age of 10 to be seated in the rear seat and buckled; 66.3% of respondents favor the current law requiring all new vehicles to be equipped with dual-front airbags; although 54.0% of respondents state they have the same opinion toward airbags that they did three years ago, there is clear evidence that women are developing less favorable attitudes toward the technology; if given the opportunity to do so, 29.0% of respondents, when buying their next vehicle, would be likely to request that the dealer disconnect the airbag system; if their next vehicle were equipped with a manual cutoff switch, 33.0% of respondents can imagine circumstances where they would turn the airbag system off at the start of a trip. The survey results suggest that there is a widespread public support for airbags in the United States. However, this support is contingent to some extent on a variety of misperceptions about the technology. There is also substantial public support for policies to reduce the dangers of airbags, such as requiring children under the age of 10 to sit in the rear seat and wear safety belts. The public is also interested in improved airbag systems. KW - Air bag disconnection KW - Air bags KW - Attitudes KW - Child restraint systems KW - Children KW - Data collection KW - Deployment KW - Drivers KW - Dual front air bags KW - Fatalities KW - Female drivers KW - Females KW - Hazard perception KW - Hazards KW - Infants KW - Injuries KW - Knowledge KW - Laws KW - Passengers KW - Perception KW - Prevention KW - Public relations KW - Public support KW - Rearward facing child seat KW - Risk assessment KW - Seat belt usage KW - Seat belts KW - Seat positioning KW - Seating position KW - Seats KW - Side air bags KW - Surveys KW - Thresholds KW - Vehicle front end UR - https://trid.trb.org/view/573557 ER - TY - RPRT AN - 00744958 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT LOSS OF CONTROL AND SUBSEQUENT COLLISION WITH TERRAIN CESSNA 177B, N35207. CHEYENNE, WYOMING, APRIL 11, 1996 PY - 1997/03/11 SP - 61 p. AB - This report explains the accident involving a Cessna 177B airplane that collided with terrain after a loss of control following takeoff from runway 30 at the Cheyenne Airport, Cheyenne, Wyoming, on April 11, 1996. Safety issues in the report include fatigue, the effects of media attention and itinerary pressure, and aeronautical decision making. A recommendation concerning the circumstances of this accident and the importance of aeronautical decision making was made to the Aircraft Owners and Pilots Association, the Experimental Aircraft Association, and the National Association of Flight Instructors. Recommendations concerning aeronautical decision making and the hazards of fatigue and itinerary pressure were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Airline pilots KW - Aviation safety KW - Crash investigation KW - Flight training KW - Human error KW - Human factors in crashes KW - Pilot training KW - Private aircraft KW - Small aircraft KW - Wyoming UR - https://trid.trb.org/view/472355 ER - TY - RPRT AN - 00744959 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: WHEELS-UP LANDING, CONTINENTAL AIRLINES FLIGHT 1943, DOUGLAS DC-9 N10556, HOUSTON, TEXAS, FEBRUARY 19, 1996 PY - 1997/02/11 SP - 93 p. AB - This report explains the wheels-up landing of Continental Airlines flight 1943, N10556, a Douglas DC-9 at Houston Intercontinental Airport, Houston, Texas. The safety issues discussed in the report include checklist design, flightcrew training, adherence to standard operating procedures, adequacy of Federal Aviation Administration (FAA) surveillance, and flight attendant tailcone training. Safety recommendations concerning these issues were made to the FAA. KW - Air transportation crashes KW - Continental Airlines KW - Crash investigation KW - Flight crews KW - Flight training KW - Houston (Texas) KW - Landing gear UR - http://ntl.bts.gov/lib/1000/1100/1159/812.pdf UR - https://trid.trb.org/view/472356 ER - TY - RPRT AN - 00738583 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD AIRCRAFT ACCIDENT REPORT: WHEELS-UP LANDING CONTINENTAL AIRLINES FLIGHT 1943 DOUGLAS DC-9, N10556, HOUSTON, TEXAS, FEBRUARY 19, 1996 PY - 1997/02 SP - 100 p. AB - The report explains the wheels-up landing of Continental Airlines flight 1943, N10556, a Douglas DC-9 at Houston International Airport, Houston, TX. The safety issues discussed in the report include checklist design, flightcrew training, adherence to standard operating procedures, adequacy of Federal Aviation Administration (FAA) surveillance, and flight attendant tailcone training. Safety recommendations concerning these issues were made to FAA. KW - Air transportation crashes KW - Aircraft safety KW - Aviation safety KW - Crash reports KW - Landing UR - https://trid.trb.org/view/572695 ER - TY - RPRT AN - 00885980 AU - National Transportation Safety Board TI - DERAILMENT OF AMTRAK TRAIN NO. 12 AND SIDESWIPE OF AMTRAK TRAIN NO. 79 ON PORTAL BRIDGE NEAR SECAUCUS, NEW JERSEY, NOVEMBER 23, 1996. PY - 1997 IS - PB97-917002 AB - No abstract provided. KW - Emergency communication systems KW - Railroad crashes KW - Railroads KW - Secaucus (New Jersey) UR - http://ntl.bts.gov/lib/8000/8400/8417/SIR9701.pdf UR - https://trid.trb.org/view/579067 ER - TY - RPRT AN - 00881766 AU - National Transportation Safety Board TI - COLLISION AND DERAILMENT OF MARYLAND RAIL COMMUTER MARC TRAIN 286 AND NATIONAL RAILROAD PASSENGER CORPORATION AMTRAK TRAIN 29 NEAR SILVER SPRING, MARYLAND, FEBRUARY 16, 1996 / RAILROAD ACCIDENT REPORT NATIONAL TRANSPORTATION SAFETY BOARD.. PY - 1997 AB - No abstract provided. KW - Railroad crashes KW - Railroads KW - Silver Spring (Maryland) KW - Tank cars UR - https://trid.trb.org/view/568014 ER - TY - CONF AN - 00753540 AU - National Transportation Safety Board TI - PROCEEDINGS OF THE NATIONAL TRANSPORTATION SAFETY BOARD PUBLIC FORUM OM AIR BAGS AND CHILD PASSENGER SAFETY PY - 1997 SP - 500p AB - The National Transportation Safety Board convened a 4-day public forum from March 17 to March 20, 1997, to discuss concerns related to the effectiveness of air bags, passenger vulnerability to injuries from air bag deployment, other countries' experience with air bags, and ways to increase seatbelt and child restraint use. The forum identified the need for safety improvements in four areas: a) changing societal attitudes about buckling up; b) better evaluation of seatbelt use rates; c) better air bag design; and d) better evaluation of changes to air bags. Safety recommendations addressing these areas were made to the Governors and legislative leaders of the 50 States and U.S. Territories; the Mayor and Council of the District of Columbia; the U.S. Conference of Mayors; the National League of Cities; the National Associations of Counties; National Association of Towns and Townships; members of the International Association of Chiefs of Police; the National Highway Traffic Safety Administration; the domestic and international automobile manufacturers; the Centers of Disease Control and Prevention, etc. The proceedings include the transcript of the public forum and information about related safety issues that the Safety Board addressed in its 1996 study, "The Performance and Use of Child Restraint Systems, Seatbelts, and Air Bags for Children in Passenger Vehicles". U1 - National Transportation Safety Board Public Forum on Air Bags and Child Passenger Safety. Report of Proceedings NTSB/RP-97/01National Transportation Safety BoardWashington, DC StartDate:19970317 EndDate:19970320 Sponsors:National Transportation Safety Board KW - Air bags KW - Child restraint systems KW - Child safety KW - Children KW - Passenger safety KW - Passengers KW - Public opinion KW - Research KW - Safety KW - Safety equipment KW - Safety research KW - Seat belt usage KW - Seat belts KW - Transportation safety UR - http://ntl.bts.gov/lib/8000/8400/8415/RP9701.pdf UR - http://ntl.bts.gov/lib/8000/8400/8415/RP9701.pdf UR - https://trid.trb.org/view/539095 ER - TY - RPRT AN - 00885979 AU - National Transportation Safety Board TI - PROTECTING PUBLIC SAFETY THROUGH EXCAVATION DAMAGE PREVENTION: SAFETY STUDY. PY - 1997 IS - NTSB/SS-97/01 AB - No abstract provided. KW - Crashes KW - Excavations KW - Pipelines KW - Safety KW - Underground pipelines KW - Underground structures KW - United States UR - https://trid.trb.org/view/579066 ER - TY - RPRT AN - 00738618 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD RAILROAD ACCIDENT REPORT: DERAILMENT OF FREIGHT TRAIN H-BALTI-31, ATCHISON, TOPEKA AND SANTA FE RAILROAD COMPANY NEAR CAJON JUNCTION, CALIFORNIA ON FEBRUARY 1, 1996 PY - 1996/12/11 SP - 86 p. AB - On February 1, 1996, Atchison, Topeka and Santa Fe Railway Company freight train H-BALT1-31 derailed at milepost 60.4 near Cajun Junction, California. The conductor and the brakeman sustained fatal injuries. A fire resulting from the derailment and subsequent rail car pileup engulfed the train and adjacent areas. The major safety issues discussed in the report are the lack of Federal and management oversight in the use of two-way end-of-train devices, the adequacy of operating personnel training in the use of two-way end-of-train devices, the carrier compliance with Federal regulations for event recorders, and the adequacy of wreckage removal operations for tank cars containing hazardous materials. The report also discusses safety issues relating to standards for brake pipe configurations, crashworthiness and occupant survivability, and emergency response and evacuation. KW - Derailments KW - Federal laws KW - Federal regulations KW - Management KW - Management control systems KW - Railroad crashes KW - Safety KW - Safety standards KW - Standards KW - Training UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9605.pdf UR - https://trid.trb.org/view/572718 ER - TY - RPRT AN - 00735872 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: GROUND SPOILER ACTIVATION IN FLIGHT/HARD LANDING VALUJET AIRLINES FLIGHT 558 DOUGLAS DC-9-32, N922VV NASHVILLE, TENNESSEE JANUARY 7, 1996 PY - 1996/12/11 SP - 182 p. AB - This report explains the ground spoiler activation in flight and subsequent hard landing of ValuJet Airlines flight 558, N922VV, a Douglas DC-9-32 at Nashville International Airport, Nashville, Tennessee. The safety issues discussed in the report include the adequacy of ValuJet's operations and maintenance manuals, specifically winter operations nosegear shock strut servicing procedures; the adequacy of ValuJet's pilot training/crew resource management training programs; flightcrew actions/ decisionmaking; the role of communications (flightcrew/flight attendants/operations/dispatch/air traffic control); ValuJet's flightcrew pay schedule; Federal Aviation Administration (FAA) oversight of ValuJet; and the adequacy of cockpit voice recorder (CVR) duration and procedures. Safety recommendations concerning these issues were made to the FAA and ValuJet Airlines. KW - Air traffic control KW - Air transportation crashes KW - Aircraft KW - Aircraft landings KW - Aircraft maintenance KW - Aircraft operations KW - Cockpits KW - Communications KW - Flight crews KW - Flight training KW - Ground handling KW - Hard landings KW - Landing KW - Manuals KW - Oversight KW - Payment KW - Speech KW - Spoilers KW - Vehicle maintenance KW - Voice communication KW - Winter maintenance KW - Winter service UR - http://ntl.bts.gov/lib/1000/1100/1121/6781.pdf UR - https://trid.trb.org/view/478465 ER - TY - RPRT AN - 00735873 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY DEPARTURE DURING ATTEMPTED TAKEOFF TOWER AIR FLIGHT 41 BOEING 747-136, N605FF JFK INTERNATIONAL AIRPORT, NEW YORK DECEMBER 20, 1995 PY - 1996/12/02 SP - 98 p. AB - This report explains the runway departure during attempted takeoff of Tower Air flight 41, N605FF, a Boeing 747-136 at John F. Kennedy International Airport, New York, on December 20, 1995. The safety issues discussed in this report include the adequacy of Boeing and air carrier procedures for B-747 operations on slippery runways; adequacy of flight simulators for training B-747 pilots in slippery runway operations; security of galley equipment installed on transport category aircraft; role of communications among flight attendants and between the cabin crew and the flightcrew; adequacy of Tower Air galley security training; compliance of Tower Air's maintenance department with its established procedures; failure of the flight data recorder (FDR) system to function during the accident; adequacy of the Tower Air operational management structure; adequacy of FAA surveillance and workload imposed on principal operations inspectors (POIs); adequacy of runway friction measurement requirements, including correlation of runway friction measurements with aircraft braking and ground handling performance. Safety recommendations concerning these issues were made to the Federal Aviation Administration (FAA) and Tower Air, Incorporated. KW - Air transportation crashes KW - Airline pilots KW - Airport runways KW - Braking KW - Communications KW - Flight recorders KW - Flight simulators KW - Flight training KW - Friction KW - Galley equipment security KW - Management KW - Measurement KW - Organization charts KW - Pilot training KW - Runway departures KW - Slipperiness KW - Takeoff KW - Workload UR - http://ntl.bts.gov/lib/1000/1100/1119/878.pdf UR - https://trid.trb.org/view/478466 ER - TY - RPRT AN - 01003103 AU - National Transportation Safety Board TI - Marine Accident/Incident Summary Report: Capsizing of Questar Motorboat and Drowning of Operator, South of Shelter Island Near Juneau, Alaska, August 21, 1994 PY - 1996/11/26 SP - 38p AB - This summary report discusses a 1994 fatal accident in which a disabled 18-foot Questar Motorboat with the vessel's owner and one passenger aboard capsized while being towed by the Coast Guard Auxiliary vessel PUPPET near Juneau, Alaska. The safety issues discussed in this report are communications during the 1994 Golden North Salmon Derby, policy on the use of Coast Guard Auxiliary resources in hazardous weather and sea conditions, policy on removal of passengers from towed vessels, risk assessment training of Coast Guard Auxiliary personnel involved in search and rescue operations, and policy on postaccident toxicological testing of Coast Guard Auxiliary personnel involved in marine accidents. KW - Alaska KW - Capsizing KW - Communications KW - Crash causes KW - Crash investigation KW - Crash reports KW - Fatalities KW - Maritime safety KW - Recommendations KW - Risk assessment KW - Search and rescue operations KW - Towboat operations KW - Towed vessels KW - United States Coast Guard KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/MAR9601S.pdf UR - https://trid.trb.org/view/759460 ER - TY - RPRT AN - 00735874 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT LOSS OF PROPELLER BLADE FORCED LANDING, AND COLLISION WITH TERRAIN ATLANTIC SOUTHEAST AIRLINES, INCORPORATED, FLIGHT 529 EMBRAER EMB-120RT, N256AS CARROLLTON, GEORGIA AUGUST 21, 1995 PY - 1996/11/26 SP - 119 p. AB - This report explains the accident involving Atlantic Southeast Airlines flight 529, an EMB-120RT airplane, which experienced the loss of a propeller blade and crashed during an emergency landing near Carrollton, Georgia, on August 21, 1995. Safety issues in the report focused on manufacturer engineering practices, propeller blade maintenance repair, propeller testing and inspection procedures, the relaying of emergency information by air traffic controllers, crew resource management training, and the design of crash axes carried in aircraft. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air traffic controllers KW - Air transportation crashes KW - Crash ax design KW - Disasters and emergency operations KW - Emergencies KW - Emergency response KW - Fatalities KW - Flight KW - Inflight KW - Injuries KW - Inspection KW - Landing KW - Loss and damage KW - Maintenance KW - Manufactures KW - Manufacturing standards KW - Propeller blades KW - Propeller manufacture KW - Propellers KW - Testing UR - http://ntl.bts.gov/lib/1000/1100/1118/976.pdf UR - https://trid.trb.org/view/478467 ER - TY - RPRT AN - 00735871 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: COLLISION WITH TREES ON FINAL APPROACH AMERICAN AIRLINES FLIGHT 1572 MCDONNELL DOUGLAS MD-83, N566AA EAST GRANBY, CONNECTICUT NOVEMBER 12, 1995 PY - 1996/11/13 SP - 134 p. AB - This report explains the accident involving American Airlines flight 1572, an MD-83 airplane, which was substantially damaged when it impacted trees in East Granby, Connecticut, while on approach to runway 15 at Bradley International Airport, Windsor Locks, Connecticut, on November 12, 1995. Safety issues in the report include tower shutdown procedures, non-precision approach flight procedures, precipitous terrain and obstruction identification during approach design, the issuance of altimeter settings by air traffic control, low level windshear system maintenance and recertification, and emergency evacuation issues. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air traffic control KW - Air transportation crashes KW - Aircraft KW - Aircraft maintenance KW - Altimeters KW - Approach KW - Certification KW - Emergencies KW - Evacuation KW - Final approach KW - Identification KW - Identification systems KW - Non precision approach KW - Obstruction KW - Obstructions (Navigation) KW - Shutdown procedures KW - Terrain avoidance KW - Terrain avoidance radar KW - Trees KW - Vehicle maintenance KW - Wind shear UR - https://trid.trb.org/view/478464 ER - TY - RPRT AN - 00736918 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION OF WASHINGTON METROPOLITAN AREA TRANSIT AUTHORITY TRAIN T-111 WITH STANDING TRAIN AT SHADY GROVE PASSENGER STATION, GAITHERSBURG, MARYLAND, JANUARY 6, 1996 PY - 1996/10/29 SP - 104 p. AB - On January 6, 1996, Washington Metropolitan Area Transit Authority (WMATA) Metrorail subway train No. T-111 failed to come to a stop at the above-ground Shady Grove, Maryland, passenger station, the final station on the Metrorail Red Line. The four-car train ran by the station platform and continued about 470 ft (143 m) into the Metrorail yard north of the station, where it struck a standing, unoccupied subway train that was awaiting assignment. The operator of train T-111 was fatally injured; the train's two passengers were not injured. Total property damages were estimated to be between $2.1 and $2.6 million. The safety issues discussed in this report are adequacy and appropriateness of WMATA methods of management, decision making, and communication; safety implications of the decision to eliminate routine manual train operation on the Metrorail system; effectiveness of using performance levels to control train speed; compatibility between railcar braking performance and design of the automatic train control system; and adequacy of WMATA and Montgomery County emergency response procedures. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Washington Metropolitan Area Transit Authority, the Federal Transit Administration, the American Public Transit Association, the Montgomery County Fire and Rescue Commission, and all jurisdictions providing primary and secondary response to Metrorail accidents or incidents. KW - Automatic train control KW - Automatic train stop system KW - Braking performance KW - Communications KW - Crash causes KW - Crash reports KW - Decision making KW - Disasters and emergency operations KW - Emergency response KW - Failure caused accidents KW - Fatalities KW - Loss and damage KW - Management KW - Management methods KW - Manual control KW - Manual operation KW - Mechanical failure KW - Operating speed KW - Property KW - Property damage KW - Railroad trains KW - Recommendations KW - Safety issues KW - Speed KW - Subways KW - Train operations KW - Washington Metropolitan Area Transit Authority UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9604.pdf UR - https://trid.trb.org/view/479116 ER - TY - RPRT AN - 00735885 AU - National Transportation Safety Board TI - HIGHWAY/RAILROAD ACCIDENT REPORT: COLLISION OF NORTHEAST ILLINOIS REGIONAL COMMUTER RAILROAD CORPORATION (METRA) TRAIN AND TRANSPORTATION JOINT AGREEMENT SCHOOL DISTRICT 47/155 SCHOOL BUS AT RAILROAD/HIGHWAY GRADE CROSSING IN FOX RIVER GROVE, ILLINOIS, ON OCTOBER 25, 1995 PY - 1996/10/29 SP - 79 p. AB - This report explains the collision of a Northeast Illinois Regional Commuter Railroad Corporation commuter train with a Transportation Joint Agreement School District 47/155 school bus that was stopped at a railroad/highway grade crossing in Fox River Grove, Illinois on October 25, 1995. Seven school bus passengers were killed and the bus driver and 24 bus passengers were injured. From its investigation of the accident, the Safety Board identified the following safety issues: the appropriateness of the bus driver's performance; the adequacy of the school district bus routing and bus driver monitoring and evaluating procedures; the road design; the railroad/highway signal interaction; the coordination and communication between the Illinois Department of Transportation and the Union Pacific Railroad Company and their oversight of the signal system integration; and the injury and survival factors in the school bus. As a result of its investigation of this accident, the Safety Board made recommendations to the Secretary of Transportation, the Federal Highway Administration, the Federal Railroad Administration, the National Highway Traffic Safety Administration, the State of Illinois, the Illinois Department of Transportation, the Transportation Joint Agreement School District 47/155, the National Association of State Directors of Pupil Transportation Services, the American Association of State Highway and Transportation Officials, the National Association of County Engineers, the American Public Works Association, the Institute of Transportation Engineers, the Association of American Railroads, the American Short Line Railroad Association, the American Public Transit Association, and Operation Lifesaver, Inc. The Safety Board also issued urgent action recommendations following this accident to the Federal Highway Administration, the Federal Railroad Administration, and the State Directors of Transportation. KW - Bus crashes KW - Bus routes KW - Communications KW - Coordination KW - Driver monitoring KW - Driver performance KW - Drivers KW - Fatalities KW - Highway design KW - Injuries KW - Integrated systems KW - Integration KW - Interactions KW - Oversight KW - Personnel performance KW - Railroad commuter service KW - Railroad grade crossing collisions KW - Railroad grade crossings KW - Safety KW - School bus drivers KW - School bus passengers KW - School buses KW - School safety KW - Signal systems KW - Traffic crashes KW - Traffic signal control systems KW - Traffic signals UR - http://ntl.bts.gov/lib/9000/9700/9764/HAR9602.pdf UR - http://ntl.bts.gov/lib/9000/9700/9764/HAR9602.pdf UR - https://trid.trb.org/view/478478 ER - TY - RPRT AN - 00736473 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD PIPELINE SPECIAL INVESTIGATION REPORT: EVALUATION OF PIPELINE FAILURES DURING FLOODING AND OF SPILL RESPONSE ACTIONS, SAN JACINTO RIVER NEAR HOUSTON TEXAS, OCTOBER 1994 PY - 1996/09/06 SP - 72 p. AB - In mid-October 1994, major flooding occurred in the San Jacinto River flood plain near Houston, Texas. Due to the flooding, 8 pipelines ruptured and many others were undermined. Ignition of petroleum and petroleum products released into the river resulted in 574 people receiving (mostly minor) burn and inhalation injuries. The Safety Board undertook a special investigation that focused on the following safety issues: 1) the adequacy of Federal and industry standards on designing pipelines in flood plains; 2) the preparedness of pipeline operators to respond to threats to their pipelines from flooding and to minimize the potential for product releases; and, 3) the preparedness of the nation to minimize the consequences of petroleum releases. The report also addresses the need for effective operational monitoring of pipelines and for the use of remote- or automatic-operated valves to allow for prompt detection of product releases and rapid shutdown of failed pipe segments. KW - Flood damage KW - Modulus of rupture KW - Pipeline design KW - Pipeline safety KW - Pipelines KW - Ruptures KW - Spillage KW - Spills (Pollution) KW - Standards KW - Structural design UR - http://ntl.bts.gov/lib/8000/8400/8420/SIR9604.pdf UR - http://ntl.bts.gov/lib/8000/8400/8420/SIR9604.pdf UR - https://trid.trb.org/view/478858 ER - TY - RPRT AN - 00742300 AU - National Transportation Safety Board TI - SAFETY STUDY: THE PERFORMANCE AND USE OF CHILD RESTRAINT SYSTEMS, SEATBELTS, AND AIR BAGS FOR CHILDREN IN PASSENGER VEHICLES. VOLUME 2: CASE SUMMARIES PY - 1996/09 SP - 248 p. AB - Despite the effectiveness of child restraints and lap/shoulder belts to reduce the likelihood of severe and fatal injuries, accidents continue to occur in which restrained children are being injured and killed. The Safety Board conducted this study to examine the performance and use of occupant protection systems for children -- child restraint systems, vehicle seatbelts, and air bags. The study analyzes data from 120 accidents involving at least one vehicle in which there was a child passenger younger than age 11 and in which at least one occupant was transported to the hospital. Volume 1 contains the Board's analysis of the data and its conclusions and recommendations. Volume 2 contains the summaries of the 120 accidents. The safety issues discussed in the report include (a) the dangers that passenger-side air bags pose to children; (b) factors that affect injury severity, including the use of an inappropriate restraint for a child's age, height, and weight, the improper use of the restraint, accident severity, and seat location; (c) the adequacy of Federal standards regarding the design and installation of child restraint systems; (d) the need to improve seatbelt fit for children; (e) the adequacy of public information and education on child passenger protection; and (f) the adequacy of State child restraint use laws. Safety recommendations concerning these issues were made to the National Highway Traffic Safety Administration, the Governors and legislative leaders of the 50 States, the U.S. Territories, and the Mayor of the District of Columbia; the domestic and international automobile manufacturers; and the child restraint manufacturers. KW - Age KW - Air bags KW - Child restraint systems KW - Child safety KW - Child seat belts KW - Children KW - Crash severity KW - Crashes KW - Fatalities KW - Federal laws KW - Federal regulations KW - Height KW - Injuries KW - Injury severity KW - Installation KW - Motor vehicle accidents KW - Passenger restraints KW - Passenger safety KW - Passenger vehicles KW - Passengers KW - Restraint systems KW - Safety KW - Safety education KW - Seat belt fit KW - Seat belt standards KW - Seat belts KW - Seat location KW - Seats KW - Standards KW - Traffic crashes KW - Transportation safety KW - Weight UR - https://trid.trb.org/view/573888 ER - TY - RPRT AN - 00727102 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTAINED ENGINE FAILURE/FIRE VALUJET AIRLINES FLIGHT 597 DOUGLAS DC-9-32, N908VJ ATLANTA, GEORGIA JUNE 8, 1995 PY - 1996/07/30 SP - 137 p. AB - This report explains the uncontained engine failure/fire on Valujet Airlines flight 597, a Douglas DC-9-32, N908VJ, at Atlanta Georgia, on June 8, 1995. The safety issues discussed in the report include the clarity of operations specifications for repair stations, recordkeeping requirements for foreign repair stations, regulatory guidance concerning maintenance documentation, intent of "serviceable tags," independently powered public address systems on all transport-category airplanes, flight attendant training programs and manuals, enforcement of occupant restraint requirements, notification of flightcrew of cabin fire, cabin material/fire safety standards, flight attendant attire, and quality of cockpit voice recordings. Safety recommendations concerning these issues were made to the Federal Aviation Administration (FAA). KW - Air transportation crashes KW - Aircraft cabins KW - Clothing KW - Cockpits KW - Crash reports KW - Documentation KW - Documents KW - Engine failures KW - Fire prevention KW - Fire retardants KW - Fires KW - Flight crews KW - Injuries KW - Maintenance KW - Materials KW - Mechanical failure KW - Occupant restraint KW - Public address systems KW - Recordkeeping KW - Restraint systems KW - Safety KW - Serviceable tags KW - Specifications KW - Speech KW - Training programs KW - Valujet (Airline) KW - Voice communication UR - https://trid.trb.org/view/461410 ER - TY - RPRT AN - 00816436 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: DERAILMENT OF AMTRAK TRAIN 49 ON CONRAIL TRACKAGE NEAR BATAVIA, NEW YORK, ON AUGUST 3, 1994 PY - 1996/07/11 SP - 49 p. AB - On August 3, 1994, westbound Amtrak (National Railroad Passenger Corporation) train 49 derailed on Conrail (Consolidated Rail Corporation) trackage at milepost 406.7 near Batavia, New York. Ten crewmembers and 108 passengers sustained injuries. The major safety issues included in this report are the lack of Federal and industry guidelines for flattened rail head conditions and the integrity of passenger car seats. The report also discusses the timeliness and adequacy of emergency response services. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the Federal Railroad Administration, the National Railroad Passenger Corporation, the Association of American Railroads, and the American Short Line Railroad Association. KW - Amtrak KW - Batavia (New York) KW - Conrail KW - Crash reports KW - Derailments KW - Emergency response KW - Injuries KW - Passenger car seats (Railroads) KW - Railhead KW - Railroad crashes KW - Recommendations UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9602.pdf UR - https://trid.trb.org/view/690737 ER - TY - RPRT AN - 01003099 AU - National Transportation Safety Board TI - Marine Accident Report: Fire On Board the U.S. Fishing Vessel Alaska Spirit, Seward, Alaska, May 27, 1995 PY - 1996/06/11 SP - 86p AB - About 0200 on May 27, 1995, the U.S. fish processing vessel Alaska Spirit caught fire and burned while moored alongside a dock at the Seward Marine Industrial Center, Seward, Alaska. Firefighters extinguished the fire at 1100. The master of the vessel died, and damage to the vessel was estimated at $3 million. The safety issues addressed in the following report are: adequacy of noncombustible construction standards for uninspected commercial fishing industry vessels; adequacy of fire detection and fire suppression equipment; drills and readiness of on-board firefighting hoses; and existing vessel fire safety standards. As a result of its investigation, the National Transportation Safety Board made safety recommendations to the U.S. Coast Guard, The Fishing Company of Alaska, Incorporated, the Commercial Fishing Industry Vessel Safety Advisory Committee, and the National Fire Protection Association. KW - Alaska KW - Crash causes KW - Crash investigation KW - Crash reports KW - Fatalities KW - Fire KW - Fire causes KW - Fire detection systems KW - Fire extinguishers KW - Fire fighting KW - Fire fighting equipment KW - Fishing vessels KW - Loss and damage KW - Maritime safety KW - Recommendations KW - Shipbuilding KW - Standards KW - Water transportation crashes UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/mar9601.pdf UR - https://trid.trb.org/view/759461 ER - TY - RPRT AN - 00724516 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT: ROBINSON HELICOPTER COMPANY R22 LOSS OF MAIN ROTOR CONTROL ACCIDENTS PY - 1996/04/02 SP - 112 p. AB - This report examines the loss of main rotor control accidents involving Robinson Helicopter Company R22 helicopters. The safety issues discussed in the report include the need for appropriate measures to reduce the probability of loss of main rotor control accidents; the need for continued research to study flight control systems and main rotor blade dynamics in lightweight, low rotor inertia helicopters; the need for operational requirements to be addressed during future certification of lightweight, low rotor inertia helicopters; and the need for the Federal Aviation Administration (FAA) to review and revise, as necessary, its procedures to ensure that internal recommendations, particularly those addressed in special certification reviews, are appropriately resolved and brought to closure. Safety recommendations concerning these issues were made to the FAA and the National Aeronautics and Space Administration. KW - Air transportation crashes KW - Certification KW - Crash investigation KW - Dynamics KW - Flight control systems KW - Helicopters KW - Inertia (Mechanics) KW - Lightweight materials KW - Loss of control KW - Loss of control accidents KW - Rotor blades KW - Rotors UR - https://trid.trb.org/view/460361 ER - TY - RPRT AN - 00816435 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION AND DERAILMENT OF TWO SUBWAY TRAINS, METROPOLITAN TRANSPORTATION AUTHORITY, NEW YORK CITY TRANSIT IN BROOKLYN, NEW YORK, ON FEBRUARY 9, 1995 PY - 1996/03/19 SP - 57 p. AB - On February 9, 1995, a Metropolitan transportation Authority/New York City Transit subway train collided with a stopped subway train. The rear-end collision, in which 11 passengers and 4 transit employees sustained minor injuries, occurred on elevated track south of the Ninth Avenue station in Brooklyn, New York. The major safety issues discussed in this report are the effectiveness of automatic stop arms to ensure compliance with stop signals and the adequacy of transit system oversight to ensure compliance with operating rules. The report also includes safety issues relating to speedometers, radios, positive train separation, crashworthiness and occupant survivability, and emergency response. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the Metropolitan Transportation Authority/New York City Transit. KW - Automatic stop arms KW - Brooklyn (New York, New York) KW - Compliance KW - Crash investigation KW - Crash reports KW - Crashworthiness KW - Elevated guideways KW - Emergency response KW - Injuries KW - Operating rules KW - Oversight KW - Positive train separation KW - Radio KW - Railroad crashes KW - Railroad signals KW - Rear end crashes KW - Recommendations KW - Speedometers KW - Subways UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/RAR9601.pdf UR - https://trid.trb.org/view/690736 ER - TY - RPRT AN - 00722100 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. AIR CARRIER OPERATIONS CALENDAR YEAR 1994 PY - 1996/03/18 SP - 73 p. AB - This publication presents the record of aviation accidents involving revenue operations of U.S. Air Carriers, including Commuter Air Carriers and On Demand Air Taxis for calendar year 1994. The report is divided into three major sections according to the federal regulations under which the flight was conducted - 14 CFR 121, Scheduled 14 CFR 135, or Nonscheduled 14 CFR 135. In each section of the report, tables are presented to describe the losses and characteristics of 1994 accidents to enable comparison with prior years. KW - Air taxi service KW - Air transportation crashes KW - Airlines KW - Alternatives analysis KW - Characteristics KW - Commuter airlines KW - Crash data KW - Crash rates KW - Federal laws KW - Federal regulations KW - Losses KW - Revenues KW - Tables (Data) UR - https://trid.trb.org/view/459510 ER - TY - RPRT AN - 00722132 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: HIGHWAY/RAIL GRADE CROSSING COLLISION NEAR SYCAMORE, SOUTH CAROLINA MAY 2, 1995 PY - 1996/03/11 SP - 102 p. AB - On May 2, 1995, a truck consisting of a tractor and a lowbed semitrailer became lodged on a high-profile (hump) railroad grade crossing near Sycamore, South Carolina. About 35 minutes later, the truck was struck by southbound Amtrak train No. 81 en route from New York City to Tampa, Florida. No deaths resulted from the accident, but 33 persons sustained minor injuries. Combined property damage to the truck and train exceeded $1 million. The following issues in grade crossing safety are discussed in this report: identification and warnings of hump crossings, emergency notifications at grade crossings, and adequacy of training for commercial drivers. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Secretary of Transportation; the Federal Highway Administration; the American Public Transit Association; the American Association of Motor Vehicle Administrators; the American Trucking Associations, Inc.; the American Short Line Railroad Association; Operation Lifesaver, Inc.; all Class I railroads and railroad systems; and O&J Gordon Trucking Company. KW - Amtrak KW - Crash reports KW - Identification KW - Identification systems KW - Injuries KW - Loss and damage KW - Property KW - Property damage KW - Railroad grade crossing collisions KW - Railroad grade crossings KW - Railroad trains KW - Speed control humps KW - Tractor trailer combinations KW - Traffic crashes KW - Training KW - Truck drivers KW - Warning systems UR - http://ntl.bts.gov/lib/9000/9700/9765/HAR9601.pdf UR - http://ntl.bts.gov/lib/9000/9700/9765/HAR9601.pdf UR - https://trid.trb.org/view/459541 ER - TY - RPRT AN - 00722087 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. GENERAL AVIATION CALENDAR YEAR 1994 PY - 1996/02/01 SP - 86 p. AB - This report presents a statistical compilation and review of general aviation accidents which occurred in 1994 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving U.S. registered aircraft not conducting operations under 14 CFR 121, 14 CFR 127, or 14 CFR 135. This report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents and Midair Collision Accidents. Several tables present accident parameters for 1994 accidents only, and each section includes tabulations which present comparative statistics for 1994 and for the ten-year period 1984-1993. KW - Air transportation crashes KW - Crash data KW - Fatalities KW - General aviation KW - Injuries KW - Loss and damage KW - Midair crashes KW - Property KW - Property damage KW - Tables (Data) UR - https://trid.trb.org/view/459497 ER - TY - RPRT AN - 00722078 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT: AIR TRAFFIC CONTROL EQUIPMENT OUTAGES PY - 1996/01/23 SP - 45 p. AB - This report examines the outages involving computer and related equipment in certain air route traffic control centers (ARTCCs). The safety issues discussed in the report include the increasing frequency of outages involving the aging IBM 9020E computer equipment; other equipment outages involving power systems and communications equipment unrelated to the aging IBM computer systems; lack of controller proficiency with one of the backup computer systems; the increased likelihood that some ARTCC computer systems will be operated with compromised redundancy; and the adverse effect of the retirement of highly skilled airways facilities technicians on the Federal Aviation Administration's (FAA) ability to maintain and repair many air traffic control systems. Safety recommendations concerning these issues were made to the FAA. KW - Aging KW - Air traffic control KW - Air traffic controllers KW - Computer outages KW - Computer systems KW - Computers KW - Maintenance personnel KW - Mechanical failure KW - Reliability UR - https://trid.trb.org/view/459488 ER - TY - RPRT AN - 00860482 AU - National Transportation Safety Board TI - UGI UTILITIES, INC. NATURAL GAS DISTRIBUTION PIPELINE EXPLOSION AND FIRE, ALLENTOWN, PENNSYLVANIA, JUNE 9, 1994: PIPELINE ACCIDENT REPORT. PY - 1996 IS - PB96-916501 AB - No abstract provided. KW - Allentown (Pennsylvania) KW - Failure KW - Natural gas pipelines KW - Pennsylvania KW - Pipelines UR - https://trid.trb.org/view/523031 ER - TY - RPRT AN - 00880725 AU - UNITED STATES. COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION. FOR SALE BY THE U.S. G.P.O., SUPT. OF DOCS., CONGRESSIONAL SALES OFFICE AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD REAUTHORIZATION AND PIPELINE SAFETY ACT REAUTHORIZATION: HEARING BEFORE THE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION, UNITED STATES SENATE, ONE HUNDRED FOURTH CONGRESS, SECOND SESSION, APRIL 16, 1996.. SN - 0160538637 PY - 1996 AB - No abstract provided. KW - Pipelines KW - Regulations KW - Safety KW - United States UR - https://trid.trb.org/view/567802 ER - TY - CONF AN - 00880728 AU - SIMON, ROSALYN M AU - Planning and Transport Res and Computation Co, Ltd AU - National Transportation Safety Board TI - STATUS OF TRANSPORTATION ACCESSIBILITY IN THE UNITED STATES: IMPACT OF THE AMERICANS WITH DISABILITIES ACT. PY - 1996 AB - No abstract provided. U1 - PERSONAL ACCESS AND MOBILITY KW - Laws and legislation KW - Persons with disabilities KW - United States UR - https://trid.trb.org/view/570050 ER - TY - CONF AN - 00880727 AU - McKee, Campbell AU - Planning and Transport Res and Computation Co, Ltd AU - National Transportation Safety Board TI - ACCESSIBLE TRANSPORT: MARKET FORCES VERSUS HUMAN RIGHTS?. PY - 1996 AB - No abstract provided. U1 - PERSONAL ACCESS AND MOBILITY KW - Accessibility KW - Barrier free design KW - Buses KW - Design KW - Persons with disabilities KW - Transportation UR - https://trid.trb.org/view/570049 ER - TY - CONF AN - 00880729 AU - MATTHEWS, BRYAN AU - Gleave, Steer Davies AU - Planning and Transport Res and Computation Co, Ltd AU - National Transportation Safety Board TI - THE DISABILITY DISCRIMINATION ACT AND PUBLIC TRANSPORT PROVISION: AN ANALYSIS OF THE ACT AND ITS EXPECTED EFFECTS WITH REFERENCE IN THE USA. PY - 1996 AB - No abstract provided. U1 - PERSONAL ACCESS AND MOBILITY KW - Laws and legislation KW - Persons with disabilities KW - United Kingdom KW - United States UR - https://trid.trb.org/view/570051 ER - TY - RPRT AN - 00735888 AU - National Transportation Safety Board TI - SAFETY STUDY: THE PERFORMANCE AND USE OF CHILD RESTRAINT SYSTEMS, SEATBELTS, AND AIR BAGS FOR CHILDREN IN PASSENGER VEHICLES. VOLUME 1: ANALYSIS PY - 1996 SP - 263 p. AB - Despite the effectiveness of child restraints and lap/shoulder belts to reduce the likelihood of severe and fatal injuries, accidents continue to occur in which restrained children are being injured and killed. The Safety Board conducted this study to examine the performance and use of occupant protection systems for children -- child restraint systems, vehicle seatbelts, and air bags. The study analyzes data from 120 accidents involving at least one vehicle in which there was a child passenger younger than age 11 and in which at least one occupant was transported to the hospital. Volume 1 contains the Board's analysis of the data and its conclusions and recommendations. Volume 2 contains the summaries of the 120 accidents. The safety issues discussed in the report include (a) the dangers that passenger-side air bags pose to children; (b) factors that affect injury severity, including the use of an inappropriate restraint for a child's age, height, and weight, the improper use of the restraint, accident severity, and seat location; (c) the adequacy of Federal standards regarding the design and installation of child restraint systems; (d) the need to improve seatbelt fit for children; (e) the adequacy of public information and education on child passenger protection; and (f) the adequacy of State child restraint use laws. Safety recommendations concerning these issues were made to the National Highway Traffic Safety Administration, the Governors and legislative leaders of the 50 States, the U.S. Territories, and the Mayor of the District of Columbia; the domestic and international automobile manufacturers; and the child restraint manufacturers. KW - Age KW - Air bags KW - Child restraint systems KW - Child safety KW - Child seat belts KW - Children KW - Crash severity KW - Crashes KW - Fatalities KW - Federal laws KW - Federal regulations KW - Height KW - Injuries KW - Injury severity KW - Installation KW - Motor vehicle accidents KW - Passenger restraints KW - Passenger safety KW - Passenger vehicles KW - Passengers KW - Restraint systems KW - Safety KW - Safety education KW - Seat belt fit KW - Seat belt standards KW - Seat belts KW - Seat location KW - Seats KW - Standards KW - Traffic crashes KW - Transportation safety KW - Weight UR - http://ntl.bts.gov/lib/8000/8400/8416/SS9601.pdf UR - http://ntl.bts.gov/lib/8000/8400/8416/SS9601.pdf UR - https://trid.trb.org/view/478481 ER - TY - JOUR AN - 00867047 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Velocci, Anthony L AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - RESTRAINT, AIRLINE HEALTH KEY TO STABLE REBOUND. PY - 1996 AB - No abstract provided. KW - Airlines KW - Finance KW - Management UR - https://trid.trb.org/view/634107 ER - TY - RPRT AN - 00867056 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT ICING ENCOUNTER AND LOSS OF CONTROL, SIMMONS AIRLINES, D.B.A. AMERICAN EAGLE FLIGHT 4184, AVIONS DE TRANSPORT REGIONAL (ATR) MODEL 72-212, N401AM, ROSELAWN, INDIANA, OCTOBER 31, 1994. PY - 1996 IS - PB96-910401 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Airworthiness KW - Airworthiness certificates KW - Certification KW - Roselawn UR - https://trid.trb.org/view/630982 ER - TY - JOUR AN - 00867070 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - LOWER COSTS DRIVE NEXT-GENERATION 737. PY - 1996 AB - No abstract provided. KW - Boeing 737 aircraft UR - https://trid.trb.org/view/634108 ER - TY - JOUR AN - 00866274 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SPARACO, PIERRE AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - COMBATING FATIGUE TO ENHANCE SAFETY. PY - 1996 AB - No abstract provided. KW - Air pilots KW - Airplanes KW - Fatigue KW - Psychological aspects UR - https://trid.trb.org/view/633997 ER - TY - RPRT AN - 00866136 AU - National Transportation Safety Board TI - TRANSPORTATION TRAGEDY: AN INFORMATIONAL ASSISTANCE GUIDE FOR THOSE AFFECTED BY A MAJOR TRANSPORTATION TRAGEDY: WHAT TO EXPECT, WHO CAN HELP, HOW TO COPE.. PY - 1996 AB - No abstract provided. KW - Crash investigation KW - Disaster relief KW - Emergencies KW - Handbooks KW - Hazards and emergency operations KW - Management KW - Manuals KW - United States UR - https://trid.trb.org/view/630410 ER - TY - JOUR AN - 00866276 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SMITH, BRUCE A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FAA RESTRUCTURING AGING AIRCRAFT RESEARCH. PY - 1996 AB - No abstract provided. KW - Airplanes KW - Jet transports KW - Maintenance KW - United States UR - https://trid.trb.org/view/633999 ER - TY - JOUR AN - 00866273 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SHIFRIN, CAROLE A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AVIATION SAFETY TAKES CENTER STAGE WORLDWIDE. PY - 1996 AB - No abstract provided. KW - Aeronautics KW - Air transportation crashes KW - Safety UR - https://trid.trb.org/view/633996 ER - TY - JOUR AN - 00866275 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MANN, PAUL AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SAFETY POLITICIZED: FAA VERSUS NTSB. PY - 1996 AB - No abstract provided. KW - Aeronautics KW - Safety KW - United States UR - https://trid.trb.org/view/633998 ER - TY - JOUR AN - 00864120 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - DORNHEIM, MICHAEL A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - RECOVERED FMC MEMORY PUTS NEW SPIN ON CALI ACCIDENT. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Cali (Colombia) UR - https://trid.trb.org/view/632560 ER - TY - JOUR AN - 00864065 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - NORDWALL, BRUCE D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - MILITARY ORDERS OUTPACE CIVIL DEMAND FOR SIMULATORS. PY - 1996 AB - No abstract provided. KW - Flight simulators UR - https://trid.trb.org/view/632547 ER - TY - JOUR AN - 00864063 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MORROCCO, JOHN D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FLA PARTNERS REACH WORKSHARE AGREEMENT. PY - 1996 AB - No abstract provided. KW - Airplanes KW - Design KW - Jet transports KW - Size UR - https://trid.trb.org/view/632545 ER - TY - JOUR AN - 00864119 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SHIFRIN, CAROLE A AU - SPARACO, PIERRE AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - BOEING, AIRBUS DIFFER ON LARGE-AIRCRAFT ISSUES. PY - 1996 AB - No abstract provided. KW - Design KW - Jet transports KW - Size UR - https://trid.trb.org/view/632559 ER - TY - JOUR AN - 00864573 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - VALUJET RESUMES OPERATIONS TO NEW SCRUTINY AND RIVALS. PY - 1996 AB - No abstract provided. KW - Airlines KW - Management KW - United States UR - https://trid.trb.org/view/632670 ER - TY - JOUR AN - 00864580 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - ADVANCED DETECTION SYSTEMS FOCUS OF FAA TECHNICAL CENTER. PY - 1996 AB - No abstract provided. KW - Airports KW - Baggage KW - Baggage handling KW - Detectors KW - Explosives KW - Security UR - https://trid.trb.org/view/632677 ER - TY - JOUR AN - 00864519 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - COCKPIT SWITCHES FOCUS OF BOEING 777 DIRECTIVE. PY - 1996 AB - No abstract provided. KW - Aircraft navigational aids KW - Airplanes KW - Boeing 777 aircraft UR - https://trid.trb.org/view/632656 ER - TY - JOUR AN - 00864576 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - OTT, JAMES AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SOBER VIEW TAKES OVER: WHAT CAN BE DONE?. PY - 1996 AB - No abstract provided. KW - Airports KW - Prevention KW - Security KW - Terrorism UR - https://trid.trb.org/view/632673 ER - TY - JOUR AN - 00864577 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MORROCCO, JOHN D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - EUROPE MAKES STEADY PROGRESS ON AIRPORT BAGGAGE SCREENING. PY - 1996 AB - No abstract provided. KW - Airports KW - Baggage KW - Baggage handling KW - Europe KW - Prevention KW - Security KW - Terrorism UR - https://trid.trb.org/view/632674 ER - TY - JOUR AN - 00864064 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - NORDWALL, BRUCE D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AEROSPACE ADVANCES CHALLENGE TRAINING. PY - 1996 AB - No abstract provided. KW - Flight simulators KW - Technological innovations UR - https://trid.trb.org/view/632546 ER - TY - JOUR AN - 00864572 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Velocci, Anthony L AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - BANKRUPT KIWI SEEKS NEW FUNDS TO REBUILD ROUTE STRUCTURE. PY - 1996 AB - No abstract provided. KW - Airlines KW - Finance KW - Management KW - United States UR - https://trid.trb.org/view/632669 ER - TY - JOUR AN - 00864574 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - DORNHEIM, MICHAEL A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - LAX FUND TRANSFER TO CITY MAY REKINDLE OLD FEUD. PY - 1996 AB - No abstract provided. KW - Airports KW - Finance KW - Los Angeles (California) UR - https://trid.trb.org/view/632671 ER - TY - JOUR AN - 00864579 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - MIX OF TECHNOLOGIES KEY TO INCREASED SECURITY. PY - 1996 AB - No abstract provided. KW - Airports KW - Prevention KW - Technological innovations KW - Terrorism UR - https://trid.trb.org/view/632676 ER - TY - JOUR AN - 00864581 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - DOGS PLAY AT DEADLY GAME.. PY - 1996 AB - No abstract provided. KW - Airports KW - Dogs KW - Police KW - Security UR - https://trid.trb.org/view/632678 ER - TY - JOUR AN - 00864520 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - NTSB CITES DAMAGE IN SECOND TWA FUEL TANK. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - East moriches UR - https://trid.trb.org/view/632657 ER - TY - JOUR AN - 00864521 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MORROCCO, JOHN AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - COMPETITION TRANSFORMS SOUTH AFRICA'S SKIES. PY - 1996 AB - No abstract provided. KW - Air transportation KW - Airlines KW - South Africa UR - https://trid.trb.org/view/632658 ER - TY - JOUR AN - 00864575 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - OTT, JAMES AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AIRPORT SECURITY, A BROADER PLAN, NOT A SILVER BULLET'. PY - 1996 AB - No abstract provided. KW - Airports KW - Prevention KW - Security KW - Terrorism UR - https://trid.trb.org/view/632672 ER - TY - JOUR AN - 00864578 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - DORNHEIM, MICHAEL A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - NUCLEAR DETECTION OF EXPLOSIVES STILL SHOWS PROMISE. PY - 1996 AB - No abstract provided. KW - Airports KW - Detectors KW - Explosives UR - https://trid.trb.org/view/632675 ER - TY - JOUR AN - 00864715 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - GAO URGES SCRUTINY OF NEW AIRLINES. PY - 1996 AB - No abstract provided. KW - Air transportation KW - Airlines KW - Certification KW - Safety KW - United States UR - https://trid.trb.org/view/632708 ER - TY - JOUR AN - 00863933 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Velocci, Anthony L AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FUEL PRICES FAIL TO GROUND SOARING AIRLINE PROFITS. PY - 1996 AB - No abstract provided. KW - Airlines KW - Finance KW - Management KW - Operating costs KW - United States UR - https://trid.trb.org/view/632533 ER - TY - JOUR AN - 00863934 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - TWA CRASH PROBERS STUDY FUEL TANK BLAST. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - East moriches UR - https://trid.trb.org/view/632534 ER - TY - SER AN - 00862041 JO - The New Yorker PB - N/A AU - HARR, JONATHAN AU - National Transportation Safety Board TI - THE CRASH DETECTIVES: THE EXPERTS TRYING TO SOLVE THE T.W.A. DISASTER ARE HAUNTED BY THE MYSTERY OF USAIR FLIGHT 427. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Pittsburgh (Pennsylvania) UR - https://trid.trb.org/view/628919 ER - TY - JOUR AN - 00862055 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FAA UNCOVERS MORE VALUJET LAPSES. PY - 1996 AB - No abstract provided. KW - Air pilots KW - Airlines KW - Management KW - Training KW - Training of KW - United States UR - https://trid.trb.org/view/631269 ER - TY - JOUR AN - 00862056 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SAN FRANCISCO AIRPORTS BRACE FOR INCREASED TRAFFIC. PY - 1996 AB - No abstract provided. KW - Airports KW - Design KW - San Francisco Bay Area KW - Traffic control UR - https://trid.trb.org/view/631270 ER - TY - JOUR AN - 00862057 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SCOTT, WILLIAM B AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - COMPOSITE PARTS WILL PAY DIVIDENDS ON FUTURE ENGINES. PY - 1996 AB - No abstract provided. KW - Airplanes KW - Composite materials KW - Motors UR - https://trid.trb.org/view/631271 ER - TY - JOUR AN - 00861788 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SEKIGAWA, EIICHIRO AU - MECHAM, MICHAEL AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - PILOTS, A300 SYSTEMS CITED IN NAGOYA CRASH. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Japan UR - https://trid.trb.org/view/525833 ER - TY - JOUR AN - 00861627 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - MANN, PAUL AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - TERRORIST FEARS DEEPEN WITH 747'S DESTRUCTION. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - East moriches UR - https://trid.trb.org/view/525769 ER - TY - JOUR AN - 00861185 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SAFETY CONCERNS GROUND VALUJET. PY - 1996 AB - No abstract provided. KW - Aeronautics KW - Air transportation crashes KW - Florida KW - United States UR - https://trid.trb.org/view/525665 ER - TY - JOUR AN - 00861510 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - NORDWALL, BRUCE D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - NTSB: ICE CAUSED INDIANA ATR72 CRASH. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Rosetown UR - https://trid.trb.org/view/525754 ER - TY - JOUR AN - 00861629 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MANN, PAUL AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - IMAGING SYSTEMS NEED HUMAN TOUCH. PY - 1996 AB - No abstract provided. KW - Airports KW - Detectors KW - Security KW - Terrorism UR - https://trid.trb.org/view/525771 ER - TY - JOUR AN - 00861721 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - TWA PROBE ADVANCES, BUT NO CAUSE FOUND. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - East moriches UR - https://trid.trb.org/view/525824 ER - TY - JOUR AN - 00861428 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - BOEING POISED TO OFFER STRETCHED 747 VERSIONS. PY - 1996 AB - No abstract provided. KW - Boeing 747 aircraft UR - https://trid.trb.org/view/525716 ER - TY - JOUR AN - 00861430 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - VALUJET HEARINGS FOCUS ON FAA OVERSIGHT. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Miami (Florida) UR - https://trid.trb.org/view/525718 ER - TY - JOUR AN - 00861369 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - BOEING STUDIES FUTURE 777 OPTIONS. PY - 1996 AB - No abstract provided. KW - Boeing 777 aircraft UR - https://trid.trb.org/view/525699 ER - TY - JOUR AN - 00861429 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SPARACO, PIERRE AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - MASSIVE FRENCH MERGERS IMMINENT. PY - 1996 AB - No abstract provided. KW - Aerospace industry KW - France UR - https://trid.trb.org/view/525717 ER - TY - JOUR AN - 00861509 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - OTT, JAMES AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - JT8D HUB FAILURE SPARKS INTENSE INQUIRY. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Pensacola (Florida) UR - https://trid.trb.org/view/525753 ER - TY - JOUR AN - 00861511 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SHIFRIN, CAROLE A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - VALUJET TO CHANGE OPERATIONS, SEEKS AUGUST RESTART. PY - 1996 AB - No abstract provided. KW - Airlines KW - Local service airlines KW - Management KW - United States UR - https://trid.trb.org/view/525755 ER - TY - JOUR AN - 00861628 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MANN, PAUL AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - TWA DISASTER REOPENS TOUGH SECURITY ISSUES. PY - 1996 AB - No abstract provided. KW - Airports KW - Detectors KW - Prevention KW - Security KW - Terrorism UR - https://trid.trb.org/view/525770 ER - TY - JOUR AN - 00860895 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SEAMLESS SERVICE, JET AIRCRAFT DRIVE COMPETITION AMONG REGIONALS. PY - 1996 AB - No abstract provided. KW - Local service airlines KW - United States UR - https://trid.trb.org/view/525557 ER - TY - JOUR AN - 00860891 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Velocci, Anthony L AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - INDEX OF COMPETITIVENESS: EXCLUSIVE RANKINGS OF U.S. COMPANIES: SMALL SUPPLIERS OUTSPACE LARGE AEROSPACE FIRMS. PY - 1996 AB - No abstract provided. KW - Aerospace industry KW - Aircraft industry KW - United States UR - https://trid.trb.org/view/525553 ER - TY - JOUR AN - 00860893 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SHIFRIN, CAROLE A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - BRITISH AIRWAYS TRACK RECORD OFFERS COMPETITIVE PARADIGM. PY - 1996 AB - No abstract provided. KW - Airlines KW - Management KW - United Kingdom UR - https://trid.trb.org/view/525555 ER - TY - JOUR AN - 00861039 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SCOOT, WILLIAM B AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - NEW RESEARCH IDENTIFIES CAUSES OF CFIT. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Proximity detectors UR - https://trid.trb.org/view/525610 ER - TY - JOUR AN - 00860890 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SAFETY BOARD REVIEWS VALUJET OPERATIONS. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Miami (Florida) UR - https://trid.trb.org/view/525552 ER - TY - JOUR AN - 00861040 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - VALUJET HEARINGS TO PROBE FAA ROLE. PY - 1996 AB - No abstract provided. KW - Airlines KW - Airplanes KW - Maintenance KW - Management KW - United States UR - https://trid.trb.org/view/525611 ER - TY - JOUR AN - 00860892 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Velocci, Anthony L AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - EUROPE SURMOUNTING HURDLES TO BECOME A TOUGHER COMPETITOR. PY - 1996 AB - No abstract provided. KW - Aerospace industry KW - Aircraft industry KW - Europe UR - https://trid.trb.org/view/525554 ER - TY - JOUR AN - 00860894 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MECHAM, MICHAEL AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - SINGAPORE TURNS LINKAGES' INTO BUSINESS ASSET. PY - 1996 AB - No abstract provided. KW - Aerospace industry KW - Aircraft industry KW - Singapore UR - https://trid.trb.org/view/525556 ER - TY - JOUR AN - 00860683 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - UNDECLARED CARGO COMPLICATES TRANSPORT OF HAZARDOUS MATERIALS. PY - 1996 AB - No abstract provided. KW - Air transportation KW - Airplanes KW - Commodities KW - Freight traffic KW - Hazardous materials KW - Oxygen equipment KW - Transportation UR - https://trid.trb.org/view/525429 ER - TY - JOUR AN - 00860684 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - VALUJET'S ACCIDENT RATE HIGHEST AMONG LOW-COST AIRLINES. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airlines KW - United States UR - https://trid.trb.org/view/525430 ER - TY - JOUR AN - 00860889 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - NORDWALL, BRUCE D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FREE FLIGHT COULD STALL WITHOUT KEY DATA LINK: AIR TRAFFIC CONTROLLERS WILL NEED THE INFORMATION FROM ADS-B TO ENSURE FLIGHT SAFETY FOR FREE FLIGHT. PY - 1996 AB - No abstract provided. KW - Air traffic control KW - Airplanes KW - Airports UR - https://trid.trb.org/view/525551 ER - TY - JOUR AN - 00860896 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - KANDEBO, STANELY W AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - U.S. INITIATIVE AIMS TO CUT MILITARY AIRCRAFT COSTS. PY - 1996 AB - No abstract provided. KW - Aerospace industry KW - Design KW - Military aircraft KW - United States UR - https://trid.trb.org/view/525558 ER - TY - JOUR AN - 00860604 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CARGO HAZARDS ALARM VALUJET CRASH PROBERS. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Miami (Florida) UR - https://trid.trb.org/view/525412 ER - TY - JOUR AN - 00860600 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CRASH PROBE EYES OXYGEN DEVICES. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Hazardous materials KW - Miami (Florida) UR - https://trid.trb.org/view/525410 ER - TY - JOUR AN - 00860123 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Hughes, David AU - COVAULT, CRAIG AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - USAF, NTSB, CROATIA PROBE 737 CRASH. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Dubrovnik (Croatia) UR - https://trid.trb.org/view/525164 ER - TY - JOUR AN - 00860125 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - OTT, JAMES AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CITY, STATE FORCES WRANGLE OVER THIRD CHICAGO AIRPORT. PY - 1996 AB - No abstract provided. KW - Airports KW - Chicago Metropolitan Area KW - Planning UR - https://trid.trb.org/view/525166 ER - TY - RPRT AN - 00859773 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT: AIR TRAFFIC CONTROL EQUIPMENT OUTAGES. PY - 1996 IS - PB96-917001 AB - No abstract provided. KW - Air traffic control KW - Airports KW - Automation KW - Evaluation KW - Traffic control KW - United States UR - https://trid.trb.org/view/522872 ER - TY - JOUR AN - 00860117 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CANADA PRIVATIZING AIR TRAFFIC CONTROL. PY - 1996 AB - No abstract provided. KW - Air traffic control KW - Canada KW - Privatization UR - https://trid.trb.org/view/525158 ER - TY - JOUR AN - 00860124 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MORROCCO, JOHN D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - U.K. RESTRUCTURES AIR TRAFFIC CONTROL. PY - 1996 AB - No abstract provided. KW - Air traffic control KW - United Kingdom UR - https://trid.trb.org/view/525165 ER - TY - RPRT AN - 00859763 AU - National Transportation Safety Board TI - EVALUATION OF ACCIDENT DATA AND FEDERAL OVERSIGHT OF PETROLEUM PRODUCT PIPELINES. PY - 1996 IS - NTSB/SIR-96/02 AB - No abstract provided. KW - Crashes KW - Laws and legislation KW - Petroleum pipelines KW - Pipeline failures KW - United States UR - https://trid.trb.org/view/522867 ER - TY - JOUR AN - 00859788 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - SHIFRIN, CAROLE A AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - FAA REFORMS SET IN MOTION. PY - 1996 AB - No abstract provided. UR - https://trid.trb.org/view/525050 ER - TY - JOUR AN - 00859303 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Hughes, David AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AIR CANADA, CAI SPAR OVER KEY MARKETS. PY - 1996 AB - No abstract provided. KW - Airlines KW - Canada UR - https://trid.trb.org/view/524901 ER - TY - JOUR AN - 00859302 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Velocci, Anthony L AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - NEW PAN AM TO TRY AGAIN. PY - 1996 AB - No abstract provided. KW - Airlines KW - United States UR - https://trid.trb.org/view/524900 ER - TY - JOUR AN - 00859472 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - MORROCCO, JOHN D AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - ATLANTIC SEARCHED FOR CRASH CLUES. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Dominican Republic UR - https://trid.trb.org/view/524978 ER - TY - JOUR AN - 00859301 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - Proctor, Paul AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - BOEING HOMES IN ON FUTURE 747 DESIGN. PY - 1996 AB - No abstract provided. KW - Boeing 747 aircraft KW - Design UR - https://trid.trb.org/view/524899 ER - TY - JOUR AN - 00859223 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - AEROSPACE SOURCE BOOK.. PY - 1996 AB - No abstract provided. KW - Aerospace industry KW - Aircraft industry KW - Airlines UR - https://trid.trb.org/view/524891 ER - TY - JOUR AN - 00858817 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - PHILLIPS, EDWARD H AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - ALASKAN AIR SAFETY OVERHAUL URGED. PY - 1996 AB - No abstract provided. KW - Air transportation crashes KW - Alaska UR - https://trid.trb.org/view/524802 ER - TY - JOUR AN - 00858816 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - MCKENNA, JAMES T AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CRASH TRIGGERS REVIEW OF AMR. PY - 1996 AB - No abstract provided. KW - Air pilots KW - Air transportation crashes KW - California KW - Flight crews UR - https://trid.trb.org/view/524801 ER - TY - JOUR AN - 00859080 JO - Aviation Week & Space Technology PB - McGraw-Hill, Incorporated AU - NOVICHKOV, NICOLAY AU - McGraw-Hill, Incorporated AU - KIWI INTERNATIONAL AIRLINES, INC. AU - Federal Aviation Administration AU - National Transportation Safety Board TI - CIS AIR SYSTEM SEEN VERGING ON COLLAPSE. PY - 1996 AB - No abstract provided. KW - Aeronautics KW - Air transportation crashes KW - Russia (Federation) UR - https://trid.trb.org/view/524869 ER - TY - RPRT AN - 00722077 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: MULTIPLE VEHICLE COLLISION WITH FIRE DURING FOG NEAR MILEPOST 118 ON INTERSTATE 40, MENIFEE, ARKANSAS, JANUARY 9, 1995 AND SPECIAL INVESTIGATION OF COLLISION WARNING TECHNOLOGY PY - 1995/12/04 SP - 105 p. AB - On January 9, 1995, a multiple-vehicle rear-end collision occurred during localized fog on Interstate 40 near Menifee, Arkansas. The accident about 1:50 a.m. near milepost 118 eventually involved eight loaded truck tractor semitrailer combinations and one light-duty van. Four drivers and a co-driver were killed, one driver sustained a minor injury, and four drivers were uninjured. The safety issues discussed in this report include collision warning technology use during low visibility driving conditions, the emergency channel 9 override feature for citizens band radios, and the nonuniformity in State laws governing four-way emergency hazard flasher operation. As a result of its investigation, the Safety Board issued safety recommendations to the Secretary of Transportation; the National Highway Traffic Safety Administration; the Federal Communications Commission; the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, and the Territories; the Telecommunications Industry Association; the Intelligent Transportation Society of America; and the American Association of Motor Vehicle Administrators. KW - Citizen band radio KW - Crash avoidance systems KW - Fatalities KW - Flashers KW - Fog KW - Injuries KW - Interstate Highway System KW - Multiple vehicle crashes KW - Proximity detectors KW - Rear end crashes KW - Reduced visibility KW - Tractor trailer combinations KW - Vans KW - Visibility distance UR - https://trid.trb.org/view/459487 ER - TY - RPRT AN - 00722079 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: PROPANE TRUCK COLLISION WITH BRIDGE COLUMN AND FIRE, WHITE PLAINS, NEW YORK, JULY 27, 1994 PY - 1995/11/14 SP - 96 p. AB - On July 27, 1994, a tractor cargo-tank semitrailer loaded with 9,200 gallons of propane (a liquefied petroleum gas) and traveling east on Interstate 287 in White Plains, New York, drifted across the left lane onto the left shoulder and struck the guardrail. The tank hit a column of the Grant Avenue overpass. The tractor and the semitrailer separated, and the front head of the tank fractured, releasing the propane, which vaporized into gas and ignited. The tank was propelled northward about 300 ft (91.4m), landing on a frame house and engulfing it in flames. The driver was killed, 23 people were injured, and an area with a radius of approximately 400 ft (121.9m) was engulfed by fire. The safety issues discussed in this report are truck driver fatigue, carrier's oversight of the driver's work/rest cycles, countermeasures for single-vehicle roadway departures, compatibility of highway design and the operating characteristics of heavy vehicles and bridge vulnerability, and cargo tank integrity. As a result of its investigation, the National Transportation Safety Board issued recommendations to the Federal Highway Administration, the Research and Special Programs Administration, the New York State Department of Transportation, the American Association of State Highway and Transportation Officials, the American Association of Motor Vehicle Administrators, the American Trucking Association, and Paraco Gas Corporation, Inc. The Safety Board also reiterated three recommendations to the Federal Highway Administration. KW - Cargo tank integrity KW - Cargo tanks KW - Countermeasures KW - Drivers KW - Fatalities KW - Fatigue (Physiological condition) KW - Fires KW - Hazardous materials KW - Hazardous materials transportation KW - Heavy vehicles KW - Injuries KW - Propane KW - Rest periods KW - Single vehicle crashes KW - Tanks (Containers) KW - Tractor trailer combinations KW - Transportation KW - Truck drivers UR - https://trid.trb.org/view/459489 ER - TY - RPRT AN - 00722083 AU - National Transportation Safety Board TI - SAFETY STUDY: AVIATION SAFETY IN ALASKA PY - 1995/11 SP - 125 p. AB - Flight operations in Alaska are diverse, and they are responsive to the State's challenging aviation environment and its unique air transportation requirements. The National Transportation Safety Board conducted this study to examine Alaska's current aviation environment and air transportation activities, to identify the associated risk factors and safety deficiencies, and to recommend practical measures for managing the risks to safe flight operations given the reality of Alaska's aviation environment and the potential of new technologies. The following safety issues are discussed in the study: (a) the operational pressures on pilots and commercial operators to provide reliable air service in an operating environment and aviation infrastructure that are often inconsistent with these demands; (b) the adequacy of weather observing and reporting; (c) the adequacy of airport inspections and airport condition reporting; (d) the potential effects on safety of current regulations for pilot flight, duty, and rest time applicable to commuter airlines and air taxis in Alaska; (e) the adequacy of the current instrument flight rules system and the enhancements needed to reduce the reliance of Alaska's commuter airline and air taxi operations on visual flight rules; and (f) the needs of special aviation operations in Alaska. As a result of the safety study, recommendations concerning these issues were made to the Federal Aviation Administration, the United States Postal Service, the National Weather Service, and the State of Alaska. KW - Air pilots KW - Airline pilots KW - Airport inspections KW - Airside operations KW - Alaska KW - Aviation KW - Aviation safety KW - Instrument flying KW - Observations KW - Regulations KW - Risk management KW - Special aviation operations KW - Visual flight KW - Visual flight rules KW - Weather reporting KW - Weather stations UR - https://trid.trb.org/view/459493 ER - TY - RPRT AN - 00722084 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED COLLISION WITH TERRAIN FLAGSHIP AIRLINES, INC. DBA AMERICAN EAGLE FLIGHT 3379, BAE JETSTREAM 3201, N918AE MORRISVILLE, NORTH CAROLINA, DECEMBER 13, 1994 PY - 1995/10/24 SP - 116 p. AB - This report explains the accident involving American Eagle flight 3379, and BAe Jetstream 3201, which crashed about 4 nautical miles southwest of the runway 5L threshold during an instrument landing system approach to the Raleigh-Durham International Airport on December 13, 1994. Safety issues examined in this report include flight crew decisions and training, air carrier organization, hiring and record keeping practices, Federal Aviation Administration surveillance of AMR Eagle/Flagship, and the flight profile advisory system. Safety recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Airlines KW - American Eagle (Airline) KW - Approach KW - Flight profile advisory system KW - Flight training KW - Hiring policies KW - Instrument landing systems KW - Recordkeeping UR - https://trid.trb.org/view/459494 ER - TY - RPRT AN - 01003122 AU - National Transportation Safety Board TI - Marine Accident Brief Report: Fire on Board the U.S. MODU Rowan Odessa, Gulf of Mexico, December 2, 1994 PY - 1995/09/22 SP - 7p AB - This brief report explains the accident that resulted when workers struck and ruptured a submerged natural gas pipeline while positioning a mobile offshore drilling unit, the Rowan Odessa, in the Gulf of Mexico. Escaping gas ignited, engulfing the drilling rig in flames. The rig manager remains missing and is presumed dead. Damages to the drilling unit and the pipeline were estimated at $13 million. The National Transportation Safety Board determines that the probable cause of the accident is the lack of designated pipeline-free area in the Gulf of Mexico where vessels in the offshore oil industry can anchor safely. Contributing to the accident was the master's use of a NOAA chart that did not provide sufficient detailed information, such as locations of pipelines, needed for anchoring or stacking a vehicle. As a result of its investigation of this accident, the Safety Board made one new safety recommendation and reiterated one safety recommendation to the U.S. Coast Guard. KW - Anchoring KW - Crash causes KW - Crash investigation KW - Crash reports KW - Fatalities KW - Fire causes KW - Gas pipelines KW - Gulf of Mexico KW - Loss and damage KW - Marine safety KW - Mobile offshore drilling units KW - Natural gas KW - Nautical charts KW - Offshore moorings KW - Pipeline safety KW - Recommendations KW - United States Coast Guard KW - Water transportation crashes UR - https://app.ntsb.gov/doclib/reports/1996/MBR9601.pdf UR - https://trid.trb.org/view/759462 ER - TY - RPRT AN - 00722080 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. AIR CARRIER OPERATIONS CALENDAR YEAR 1993 PY - 1995/09/08 SP - 71 p. AB - This publication presents the record of aviation accidents involving revenue operations of U.S. Air Carriers, including Commuter Air Carriers and On Demand Air Taxis for calendar year 1993. The report is divided into three major sections according to the federal regulations under which the flight was conducted - 14 CFR 121, Scheduled 14 CFR 135, or Nonscheduled 14 CFR 135. In each section of the report, tables are presented to describe the losses and characteristics of 1993 accidents, to enable comparison with prior years. KW - Air taxi service KW - Air transportation crashes KW - Airlines KW - Commuter airlines KW - Crash data KW - Crash rates KW - Crashes KW - Statistics UR - https://trid.trb.org/view/459490 ER - TY - RPRT AN - 00722085 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED COLLISION WITH TERRAIN AIR TRANSPORT INTERNATIONAL DOUGLAS DC-8-63, N782AL, KANSAS CITY INTERNATIONAL AIRPORT, KANSAS CITY, MISSOURI, FEBRUARY 16, 1995 PY - 1995/08/30 SP - 151 p. AB - This report explains the accident involving an Air Transport International DC-8-63, which was destroyed by ground impact and fire during an attempted takeoff at Kansas City International Airport, Kansas City, Missouri, on February 16, 1995. Safety issues in the report include three-engine takeoff training and procedures, flight crew fatigue, company crew assignment decision making, and Federal Aviation Administration oversight of the company. Safety recommendations concerning these issues were made to the Federal Aviation Administration and Air Transport International. KW - Air transportation crashes KW - Aircraft KW - Aircraft engines KW - Engines KW - Fatigue (Physiological condition) KW - Fires KW - Flight crews KW - Flight training KW - Takeoff UR - https://trid.trb.org/view/459495 ER - TY - RPRT AN - 00722081 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY COLLISION INVOLVING TRANS WORLD AIRLINES FLIGHT 427 AND SUPERIOR AVIATION CESSNA 441, BRIDGETON, MISSOURI, NOVEMBER 22, 1994 PY - 1995/08/30 SP - 163 p. AB - This report explains the runway collision of Trans World Airlines flight 427, a McDonnell Douglas DC-9-82, and N441KM, a Cessna 441, at the intersection of runway 30R and taxiway Romeo at the Lambert-St. Louis International Airport in Bridgeton, Missouri. The safety issues discussed in the report include aircraft lighting and conspicuity; airport markings, signs, and lighting; runway 31 designation, utilization, displaced threshold; ATC and pilot phraseology (specifically, the term "back-taxi"); pilot training; runway incursion detection/prevention methods; and ASDE/AMASS development. Safety recommendations concerning some of these issues were made to the Federal Aviation Administration (FAA). KW - Air traffic control KW - Air transportation crashes KW - Airline pilots KW - Airport runways KW - Airports KW - Cessna aircraft KW - Flight training KW - Lighting KW - Markings KW - Pilot training KW - Signs KW - Trans World Airlines KW - Visibility UR - https://trid.trb.org/view/459491 ER - TY - RPRT AN - 00722086 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CRASH DURING EMERGENCY LANDING PHOENIX AIR, LEARJET 35A, N521PA, FRESNO, CALIFORNIA, DECEMBER 14, 1994 PY - 1995/08/01 SP - 74 p. AB - This report explains the accident involving the Phoenix Air Learjet 35A that crashed while attempting an emergency landing at Fresno Air Terminal, Fresno, California, on December 14, 1994. Safety issues in the report focused on maintenance, inspection and quality assurance. Safety recommendations concerning these issues were made to the Federal Aviation Administration, Phoenix Air, and the Department of Defense. KW - Air transportation crashes KW - Aircraft KW - Aircraft engines KW - Aircraft maintenance KW - Emergencies KW - Engines KW - Fires KW - Inspection KW - Landing KW - Quality assurance KW - Vehicle maintenance UR - http://www.ntsb.gov/investigations/AccidentReports/Reports/AAR9504.pdf UR - https://trid.trb.org/view/459496 ER - TY - RPRT AN - 00712495 AU - National Transportation Safety Board TI - SAFETY OF THE AIR TOUR INDUSTRY IN THE UNITED STATES. SPECIAL INVESTIGATION REPORT PY - 1995/06/01 SP - 60 p. AB - The National Transportation Safety Board has long been concerned about the occurrence of air tour accidents. From October 1, 1988, to April 1, 1995, the Safety Board has investigated 139 air tour accidents or incidents. The Safety Board has also issued several safety recommendations over the past few years directed at reducing the frequency of such accidents. As a result of this special investigation, the Safety Board has developed 11 safety recommendations to prevent future accidents and to enhance the potential for occupant survival if an accident does occur. KW - Air tour industry KW - Air transportation crashes KW - Crash investigation KW - Incidents KW - Prevention KW - Recommendations KW - Safety KW - Survival KW - Tour operators KW - Traffic incidents KW - Traffic safety UR - https://trid.trb.org/view/447929 ER - TY - RPRT AN - 00712493 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION OF AMTRAK TRAIN NO. 88 WITH ROUNTREE TRANSPORT AND RIGGING, INC., VEHICLE ON CSX TRANSPORTATION, INC., RAILROAD NEAR INTERCESSION CITY, FLORIDA, NOVEMBER 30, 1993 PY - 1995/05/16 SP - 72 p. AB - On November 30, 1993, a 184-foot-long vehicle consisting of a truck-tractor and modular transporter operated by Rountree Transport and Rigging (Rountree), Inc., was enroute to deliver an 82-ton turbine to a Kissimmee Utility Authority (KUA) electricity generating plant under construction near Intercession City, Florida. The private access road to the plant facility crosses over a single railroad track owned by CSX Transportation, Inc., (CSXT). Because of the configuration of the truck and the profile of the roadway, the cargo deck of the transporter began to bottom out on the roadway surface as the vehicle moved across the tracks and began down the descending grade. To gain sufficient clearance, the Rountree crew shimmed the transporter while the cargo deck was on the tracks. About 12:40 pm, they had finished raising the cargo deck and were preparing to move the vehicle when the lights and bells at the grade crossing activated. The gates descended, striking the turbine. Seconds later, National Railroad Passenger Corporation (Amtrak) train number 88, the Silver Meteor, carrying 89 passengers, struck the side of the cargo deck and the turbine. The locomotive and the first four cars of the eight-car consist derailed, carrying the turbine and parts of the Rountree vehicle with them. No deaths resulted from this accident. The National Transportation Safety Board determines that the probable cause of the accident was the failure of Rountree to notify CSXT in advance of its intent to cross the railroad track at the accident grade crossing and to ensure through CSXT that it was safe to do so. Contributing to the accident were deficiencies in the permitting processes of the CSXT and the Florida Department of Transportation that resulted in a lack of appropriate guidance for permitting officials, oversize, low-clearance vehicle operators and escort personnel. KW - Amtrak KW - Crash causes KW - Crash reports KW - Low floor vehicles KW - Low-clearance vehicles KW - Permits KW - Railroad grade crossings KW - Truck crashes UR - https://trid.trb.org/view/447927 ER - TY - RPRT AN - 00712496 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA. US GENERAL AVIATION CALENDAR YEAR 1993 PY - 1995/05/12 SP - 83 p. AB - This report presents a statistical compilation and review of general aviation accidents which occurred in 1993 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving US registered aircraft not conducting operations under 14 CFR 121, 12 CFR 127, or 14 CFR 135. This report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents, and Midair Collision Accidents. Several tables present accident parameters for 1993 accidents only, and each section includes tabulations which present comparative statistics for 1993 and for the nine-year period 1984-1992. KW - Air transportation crashes KW - Fatalities KW - General aviation KW - Injuries KW - Loss and damage KW - Midair crashes KW - Property KW - Property damage KW - Statistics KW - Tables (Data) UR - https://trid.trb.org/view/447930 ER - TY - RPRT AN - 00722082 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: FLIGHT INTO TERRAIN DURING MISSED APPROACH USAIR FLIGHT 1016, DC-9-31, N954VJ, CHARLOTTE/DOUGLAS INTERNATIONAL AIRPORT, CHARLOTTE, NORTH CAROLINA, JULY 2, 1994 PY - 1995/04/04 SP - 195 p. AB - This report explains the accident involving USAir flight 1016, a DC-9-31, which crashed near the Charlotte/Douglas International Airport, Charlotte, North Carolina, on July 2, 1994. Safety issues in the report include standard operating procedures for flightcrews and air traffic controllers, the dissemination of weather information to flight crews and flight crew training. Safety recommendations concerning these issues were made to the Federal Aviation Administration, USAir, and the National Weather Service. KW - Air traffic control KW - Air transportation crashes KW - Aircraft approach KW - Aircraft separation KW - Approach control KW - Crash causes KW - Fatalities KW - Flight crews KW - Injuries KW - Instrument landing systems KW - US Airways KW - Weather KW - Weather caused accidents KW - Weather communications KW - Wind shear UR - https://trid.trb.org/view/459492 ER - TY - RPRT AN - 00680501 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CONTROLLED COLLISION WITH TERRAIN TRANSPORTES AEREOS EJECUTIVOS, S.A. (TAESA) LEARJET 25D, XA-BBA, DULLES INTERNATIONAL AIRPORT, CHANTILLY, VIRGINIA, JUNE 18, 1994 PY - 1995/03/07 SP - 63 p. AB - This report explains the accident involving the TAESA Learjet 25D that crashed near the threshold of runway 1R at Dulles International Airport, Chantilly, Virginia on June 18, 1994. Safety issues in the report focused on weather at the airport, flightcrew training, qualifications, and performance, flightcrew fatigue, operations specifications, passenger seating, and the ground proximity warning system. Safety recommendations concerning some of these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Airport safety KW - Airports KW - Aviation safety KW - Crash investigation KW - Flight crews KW - U.S. Federal Aviation Administration KW - U.S. National Transportation Safety Board KW - Virginia KW - Washington Dulles International Airport UR - https://trid.trb.org/view/422119 ER - TY - RPRT AN - 00712497 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY OVERRUN FOLLOWING REJECTED TAKEOFF, CONTINENTAL AIRLINES FLIGHT 795, MCDONNELL DOUGLAS MD-82, N18835, LAGUARDIA AIRPORT, FLUSHING, NEW YORK, MARCH 2, 1994 PY - 1995/02/14 SP - 84 p. AB - This report explains the accident involving Continental Airlines flight 795, an MD-82 airplane, which experienced a runway overrun following a rejected takeoff from runway 13 at LaGuardia Airport, Flushing, New York, on March 2, 1994. Safety issues discussed in the report include the availability of takeoff performance data for flightcrews, the proper functioning of pitot/static heat systems, the duration of cockpit voice recordings, and problems associated with passenger evacuations from airplanes. Safety recommendations concerning these issues were addressed to the Federal Aviation Administration and to Continental Airlines, Inc. KW - Air transportation crashes KW - Crash reports KW - Evacuation KW - Overruns KW - Recommendations KW - Runway overruns KW - Safety KW - Takeoff UR - https://trid.trb.org/view/447931 ER - TY - RPRT AN - 00712494 AU - National Transportation Safety Board TI - SAFETY STUDY. FACTORS THAT AFFECT FATIGUE IN HEAVY TRUCK ACCIDENTS. VOLUME 1, ANALYSIS; VOLUME 2, CASE SUMMARIES PY - 1995/01 SP - 3160 p. AB - The National Transportation Safety Board analysis of Fatal Accident Reporting System (FARS) data indicates that in 1993 there were 3,311 heavy trucks involved in 3,169 fatal accidents in which 3,783 persons died (432 were occupants of the heavy trucks). Research suggested that truck driver fatigue may be a contributing factor in as many as 30 to 40 percent of all heavy truck accidents. Because of the significant number of heavy truck-related fatalities and the significant role of fatigue in such accidents, the Board initiated this study of single-vehicle heavy truck accidents to examine the role of specific factors, such as drivers' patterns of duty and sleep, and those factors affecting driver fatigue (not the statistical incidence of fatigue), and to determine potential remedial actions. The statistically significant analysis determined that the most important measures in predicting a fatigue-related accident in this sample are the duration of the last sleep period, the total hours of sleep obtained during the 24 hours prior to the accident, and the split sleep patterns. KW - Drivers KW - Fatalities KW - Fatigue (Physiological condition) KW - Heavy vehicles KW - Single vehicle crashes KW - Sleep KW - Truck crashes UR - https://trid.trb.org/view/447928 ER - TY - RPRT AN - 00859599 AU - National Transportation Safety Board TI - REAR-END COLLISION OF ATCHISON, TOPEKA AND SANTA FE RAILWAY FREIGHT TRAIN PBHLA1-10 AND UNION PACIFIC RAILROAD FREIGHT TRAIN CUWLA-10 NEAR CAJON, CALIFORNIA, DECEMBER 14, 1994: RAILROAD ACCIDENT REPORT / NATIONAL TRANSPORTATION SAFETY BOARD.. PY - 1995 IS - PB95-916304 AB - No abstract provided. KW - Cajon KW - Locomotives KW - Railroad crashes UR - https://trid.trb.org/view/522794 ER - TY - RPRT AN - 00861574 AU - National Transportation Safety Board TI - FIRE ABOARD U.S. SMALL PASSENGER VESSEL ARGO COMMODORE IN SAN FRANCISCO BAY, CALIFORNIA, DECEMBER 3, 1994. PY - 1995 IS - NTSB/MAR-95/03 AB - No abstract provided. KW - Fires KW - Marine safety KW - Passenger ships KW - San Francisco Bay KW - Water transportation crashes UR - https://trid.trb.org/view/523322 ER - TY - RPRT AN - 00861677 AU - National Transportation Safety Board TI - MARINE ACCIDENT REPORT ENGINEROOM FIRE ON BOARD THE LIBERIAN TANKSHIP SEAL ISLAND WHILE MOORED AT THE AMERADA HESS OIL TERMINAL IN ST. CROIX, U.S. VIRGIN ISLANDS, OCTOBER 8, 1994. PY - 1995 IS - PB95-916404 AB - No abstract provided. KW - Marine safety KW - Saint croix KW - Tankers KW - Water transportation crashes UR - https://trid.trb.org/view/523346 ER - TY - RPRT AN - 00858988 AU - National Transportation Safety Board TI - AVIATION SAFETY IN ALASKA: SAFETY STUDY. PY - 1995 IS - NTSB/SS-95/03 AB - No abstract provided. KW - Aeronautics KW - Air transportation crashes KW - Alaska UR - https://trid.trb.org/view/522669 ER - TY - RPRT AN - 00858980 AU - National Transportation Safety Board TI - WE ARE ALL SAFER: NTSB-INSPIRED IMPROVEMENTS IN TRANSPORTATION SAFETY.. T2 - NTSB-INSPIRED IMPROVEMENTS IN TRANSPORTATION SAFETY PY - 1995 AB - No abstract provided. KW - Aircraft safety KW - Aviation safety KW - Pipelines KW - Railroads KW - Safety KW - Ships KW - Traffic safety KW - Transportation KW - United States UR - https://trid.trb.org/view/522663 ER - TY - RPRT AN - 00858852 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY COLLISION INVOLVING TRANS WORLD AIRLINES FLIGHT 795 AND SUPERIOR AVIATION CESSNA 441, BRIDGETON, MISSOURI, NOVEMBER 22, 1994. PY - 1995 IS - PB95-910405 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Airport runways KW - Bridgeton KW - Crash investigation KW - Studies UR - https://trid.trb.org/view/522627 ER - TY - RPRT AN - 00858682 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: FLIGHT INTO TERRAIN DURING MISSED APPROACH, USAIR FLIGHT 1016, DC-9-31, N954VJ, CHARLOTTE/DOUGLAS INTERNATIONAL AIRPORT, CHARLOTTE, NORTH CAROLINA, JULY 2, 1994. PY - 1995 IS - PB95-910403 AB - No abstract provided. KW - Air transportation crashes KW - Airplanes KW - Charolotte KW - Microbursts KW - Vertical wind shear UR - https://trid.trb.org/view/522579 ER - TY - CONF AN - 00857701 AU - National Transportation Safety Board TI - EXCAVATION-DAMAGE PREVENTION WORKSHOP: PROCEEDINGS: SEPTEMBER 8-9, 1994. PY - 1995 IS - PB95-917005 AB - No abstract provided. U1 - EXCAVATION-DAMAGE PREVENTION WORKSHOPWASHINGTON, D.C.) ..CD: (1994: StartDate:00000 EndDate:00000 KW - Conferences KW - Excavations KW - Natural gas pipelines KW - Pipelines UR - https://trid.trb.org/view/522238 ER - TY - RPRT AN - 00852407 AU - National Transportation Safety Board AU - HAZARDOUS MATERIALS ACCIDENT REPORT; TI - TANK CAR FAILURE AND RELEASE OF ARSENIC ACID IN CHATTANOOGA, TENNESSEE ON JUNE 6, 1994: HAZARDOUS MATERIALS ACCIDENT REPORT. PY - 1995 IS - NTSB/HZM-95/01 AB - No abstract provided. KW - Chattanooga (Tennessee) KW - Crashes KW - Hazardous materials KW - Railroad crashes KW - Tank cars KW - Transportation UR - https://trid.trb.org/view/550558 ER - TY - RPRT AN - 00851961 AU - National Transportation Safety Board TI - FACTORS THAT AFFECT FATIGUE IN HEAVY TRUCK ACCIDENTS.. PY - 1995 IS - PB95-917001 AB - No abstract provided. KW - Fatigue KW - Rest periods KW - Truck crashes KW - Truck drivers KW - United States UR - https://trid.trb.org/view/550437 ER - TY - RPRT AN - 00852169 AU - National Transportation Safety Board TI - PIPELINE ACCIDENT REPORT: TEXAS EASTERN TRANSMISSION CORPORATION NATURAL GAS PIPELINE EXPLOSION AND FIRE, EDISON, NEW JERSEY, MARCH 23, 1994. PY - 1995 IS - PB95-916501 AB - No abstract provided. KW - Crashes KW - Edison (New Jersey) KW - Failure KW - Natural gas pipelines KW - Pipelines UR - https://trid.trb.org/view/550482 ER - TY - RPRT AN - 00674304 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT: MAINTENANCE ANOMALY RESULTING IN DRAGGED ENGINE DURING LANDING ROLLOUT, NORTHWEST AIRLINES FLIGHT 18, BOEING 747-251B, N637US, NEW TOKYO INTERNATIONAL AIRPORT, NARITA, JAPAN, MARCH 1, 1994 PY - 1994/12/20 SP - 67 p. AB - This special investigation report addresses the maintenance activity at Northwest Airlines that led to the accident involving Northwest Airlines flight 18, a B-747, during the airplane's intermediate stop at Narita, Japan, while it was flying from Hong Kong to John F. Kennedy International Airport, Jamaica, New York, on March 1, 1994. Safety issues in the report focused on maintenance operations and maintenance work environments. Safety recommendations concerning these issues were made to the Federal Aviation Administration and to Northwest Airlines. KW - Air transportation crashes KW - Aircraft KW - Aircraft maintenance KW - Boeing 747 aircraft KW - Crash investigation KW - Inspection KW - Maintenance personnel KW - Northwest Airlines KW - Vehicle maintenance UR - https://trid.trb.org/view/411922 ER - TY - RPRT AN - 00675382 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IMPACT WITH BLAST FENCE UPON LANDING ROLLOUT, ACTION AIR CHARTERS FLIGHT 990, PIPER PA-31-350, N990RA, STRATFORD, CONNECTICUT, APRIL 27, 1994 PY - 1994/12/13 SP - 76 p. AB - This report explains the accident involving Action Air Charters flight 990, a PA-31-350 airplane, which crashed into a blast fence at the end of runway 6 after the airplane landed at Sikorsky Memorial Airport, Stratford, Connecticut, on April 27, 1994. Safety issues in the report focused on the instrument landing system, runway safety areas, runway lighting systems, and aircraft maintenance. Safety recommendations concerning these issues were made to the Federal Aviation Administration, the Connecticut Department of Transportation, the City of Bridgeport, and the Town of Stratford, Connecticut. KW - Air transportation crashes KW - Aircraft KW - Aircraft maintenance KW - Blast fence KW - Fatalities KW - Fog KW - Instrument landing systems KW - Runway lighting systems KW - Runway safety areas KW - Vehicle maintenance UR - https://trid.trb.org/view/412365 ER - TY - RPRT AN - 00675383 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: COLLISION OF SMALL SCHOOL BUS AND TRACTOR-SEMITRAILER NEAR SNYDER, OKLAHOMA, NOVEMBER 10, 1993 PY - 1994/11/29 SP - 65 p. AB - About 3:28 p.m. on November 10, 1993, near Snyder, Oklahoma, a tractor-semitrailer traveling southbound on U.S. Route 183 struck a 1993 Thomas Built Minotour school bus that was crossing the highway while traveling west on County Line Road. The 20-passenger school bus was occupied by the driver and nine children. The school bus driver said that she stopped at the stop sign and then proceeded to drive across Route 183. The truck driver stated that the school bus driver hesitated and then pulled out in front of his truck. The school bus was struck in the right side behind the right-front entrance door. Eight children were not wearing the available lapbelts and were ejected. Four of the ejected children died; the injuries of the other four ranged from minor to serious. One child, the only occupant of the bus who was restrained was not ejected; he received minor injuries. The school bus driver was not ejected, but she was not wearing the lap-shoulder restraint and sustained severe injuries from contact with various parts of the bus interior. The truck driver, who stated that he was wearing his lapbelt, received minor injuries. The National Transportation Safety Board determines that the probable cause of the accident was that the school bus driver did not see the approaching truck because hew view was obstructed, because she had not been provided with an effective strategy or other means for overcoming the view obstruction, and because she may have been distracted by the unruly passengers. Contributing to the severity of the accident were the truck driver's failure to observe the speed advisory and the Cornell Construction Company's failure to systematically maintain the accident truck. The safety issues identified in this accident are the protection provided school bus occupants, the performance of the school bus driver and the view obstruction in the bus, the performance of the truck driver, and the adequacy of motor carrier oversight. As a result of the investigation of this accident, the National Transportation Safety Board makes recommendations to the National Highway Traffic Safety Administration, the Federal Highway Administration, the Governors of the 50 States and the mayor of the District of Columbia, the National Association of State Directors of Pupil Transportation Service, and the Cornell Construction Company. KW - Bus crashes KW - Crash causes KW - Crash severity KW - Driver performance KW - Drivers KW - Ejection KW - Fatalities KW - Injuries KW - Manual safety belts KW - Motor carriers KW - Oversight KW - Personnel performance KW - Recommendations KW - School bus drivers KW - School buses KW - Speeding KW - Tractor trailer combinations KW - Truck drivers KW - Truck maintenance KW - Trucks KW - Vehicle maintenance KW - View obstruction UR - https://trid.trb.org/view/412366 ER - TY - RPRT AN - 00674276 AU - National Transportation Safety Board TI - SAFETY STUDY: COMMUTER AIRLINE SAFETY PY - 1994/11 SP - 137 p. AB - The commuter airline industry has grown dramatically and has experienced significant changes in operating characteristics in the past 15 years. In response to safety recommendations issued by the National Transportation Safety Board and through other initiatives taken by government and industry, regulatory revisions and other actions have resulted in an improved safety record for commuter airlines conducting operations under Title 14 Code of Federal Regulations Part 135. However, despite efforts to bring about safety improvements, accident rates for commuter airlines continue to be higher than the rates for domestic Part 121 airlines. The higher accident rate, the differences in regulatory standards between Parts 135 and 121, and findings of the NTSB's investigations of recent accidents prompted the Board to initiate this study of commuter airline safety. The safety issues discussed in the study are: (a) the need for sweeping regulatory action; (b) the adequacy of Part 135 regulations concerning flight time limits and rest requirements; (c) the need for licensed dispatch personnel; (d) the adequacy of Part 135 pilot training; (e) the adequacy of flight attendant training practices; (f) the need for mandated safety programs at commuter airlines and for operational oversight by major air carrier code-sharing partners; (g) the training of Federal Aviation Administration inspectors and lack of uniform interpretation and enforcement of regulations by inspectors; and (g) the certification of airports served by scheduled passenger operations. As a result of the safety study, recommendations concerning these issues were made to the Federal Aviation Administration, the U.S. Department of Transportation, major U.S. domestic air carriers, and the Regional Airline Association. KW - Airport certification KW - Commuter airlines KW - Crash rates KW - Enforcement KW - Inspectors KW - Oversight KW - Recommendations KW - Regulations KW - Safety KW - Training KW - U.S. Federal Aviation Administration UR - https://trid.trb.org/view/411893 ER - TY - RPRT AN - 00674275 AU - National Transportation Safety Board TI - REPORT ON PROCEEDINGS: AVIATION ACCIDENT INVESTIGATION SYMPOSIUM, MARCH 29-31, 1994, TYSONS CORNER, VIRGINIA. VOLUME I: INDUSTRY RECOMMENDATIONS AND SAFETY BOARD RESPONSES PY - 1994/10/17 SP - 73 p. AB - Volume I contains the National Transportation Safety Board's (NTSB's) responses to a number of recommendations made by the aviation industry during the Aviation Accident Investigation Symposium held at Tysons Corner, Virginia, from March 29 through 31, 1994. Volume II contains presentations made by symposium participants. The symposium provided a forum for the aviation industry to discuss and critique NTSB programs and practices, as well as procedures used during aviation accident investigations. Participants included representatives from U.S. air carriers, airframe and engine manufacturers, aviation associations and unions, government officials and interested parties, as well as foreign investigative authorities and manufacturers. KW - Aerospace industry KW - Air transportation crashes KW - Conferences KW - Crash investigation KW - Recommendations KW - U.S. National Transportation Safety Board UR - https://trid.trb.org/view/411892 ER - TY - RPRT AN - 00670493 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: STALL AND LOSS OF CONTROL ON FINAL APPROACH, ATLANTIC COAST AIRLINES, INC./UNITED EXPRESS FLIGHT 6291, JETSTREAM 4101, N304UE, COLUMBUS, OHIO, JANUARY 7, 1994 PY - 1994/10/06 SP - 124 p. AB - This report explains the crash of United Express flight 6291, a Jetstream 4101 airplane, while on approach to runway 28L at Port Columbus International Airport, Columbus, Ohio, on January 7, 1994. The safety issues in the report focused on aircraft safety belts, training programs for Part 135 pilots that emphasize stall warning recognition and recovery techniques, and that lead to proficiency in both high speed and coupled approaches. Safety recommendations concerning these issues were made to the Federal Aviation Administration. KW - Aerodynamic stability KW - Air transportation crashes KW - Aircraft approach KW - Aircraft separation KW - Airline pilots KW - Approach control KW - Flight training KW - Manual safety belts KW - Perception KW - Pilot training KW - Recognition KW - Recommendations KW - Recovery KW - Safety KW - Stall KW - Warning signals UR - https://trid.trb.org/view/411207 ER - TY - RPRT AN - 00670381 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: OVERSPEED AND LOSS OF POWER ON BOTH ENGINES DURING DESCENT AND POWER-OFF EMERGENCY LANDING, SIMMONS AIRLINES, INC., D/B/A, AMERICAN EAGLE FLIGHT 3641, N349SB, FALSE RIVER AIR PARK, NEW ROADS, LOUISIANA, FEBRUARY 1, 1994 PY - 1994/09/27 SP - 80 p. AB - This report explains the emergency landing of American Eagle flight 3641, a Saab 340B airplane, at False River Air Park, New Roads, Louisiana, on February 1, 1994. The safety issues in the report focused on the safety hazards involved with the in-flight operation of propellers in the beta mode in airplanes for which such operation is prohibited. The National Transportation Safety Board reiterated Safety Recommendation A-94-62, which is intended to prevent the in-flight beta operation unless the airplane is certificated for such use. KW - Air transportation crashes KW - Airline pilots KW - Crash landing KW - Emergency airstrips KW - Emergency landings KW - Hazards KW - Human error KW - Human factors in crashes KW - Propeller operation in beta mode UR - https://trid.trb.org/view/411122 ER - TY - RPRT AN - 00670382 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENTS DATA: U.S. AIR CARRIER OPERATIONS, CALENDAR YEAR 1992 PY - 1994/09/15 SP - 74 p. AB - This publication presents the record of aviation accidents involving revenue operations of U.S. Air Carriers including Commuter Air Carriers and On Demand Air Taxis for calendar year 1992. The report is divided into three major sections according to the federal regulations under which the flight was conducted - 14 CFR 121, Scheduled 14 CFR 135, or Nonscheduled 14 CFR 135. In each section of the report tables are presented to describe the losses and characteristics of 1992 accidents to enable comparison with prior years. KW - 14 Cfr 121 KW - 14 Cfr 135 (Nonscheduled) KW - 14 Cfr 135 (Scheduled) KW - Air taxi service KW - Air transportation crashes KW - Airlines KW - Commuter airlines KW - Crash rates KW - Damages KW - Fatalities KW - Fires KW - Injuries KW - Loss and damage KW - Losses KW - Midair crashes KW - Periods of the day KW - Tables (Data) KW - Weather conditions UR - https://trid.trb.org/view/411123 ER - TY - RPRT AN - 00664259 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA, U.S. GENERAL AVIATION, CALENDAR YEAR 1992 PY - 1994/06/15 SP - 88 p. AB - This report presents a statistical compilation and review of general aviation accidents which occurred in 1992 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving U.S. registered aircraft not conducting operations under 14 CFR 121, 14 CFR 125, 14 CFR 127, or 14 CFR 135. This report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents; and Midair Collision Accidents. Several tables present accident parameters for 1992 accidents only, and each section includes tabulations which present comparative statistics for 1992 and for the five-year period 1987-1991. KW - Air transportation crashes KW - Aircraft KW - Aircraft damage KW - Crash causes KW - Crash rates KW - Fatalities KW - Fires KW - General aviation KW - Injuries KW - Midair crashes KW - Tables (Data) UR - https://trid.trb.org/view/405142 ER - TY - RPRT AN - 00669093 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD HIGHWAY-MARINE ACCIDENT REPORT: U.S. TOWBOAT CHRIS COLLISION WITH THE JUDGE WILLIAM SEEBER BRIDGE, NEW ORLEANS, LOUISIANA, MAY 28, 1993 PY - 1994/06/07 SP - 58 p. AB - On May 28, 1993, a towboat and an empty hopper barge collided with a support pier of the Judge William Seeber Bridge, which spans the Inner Harbor Navigation Canal in New Orleans, Louisiana. About 150 feet of the four-lane bridge deck collapsed onto the barge and into the shallow waters of the canal. Two automobiles fell with the bridge deck. One passenger died, and two others were seriously injured. The safety issues discussed in the report include the adequacy of operator performance, the timeliness of toxicological testing, and the vulnerability of this bridge and of bridges nationwide to vessel collision and collapse. KW - Crash records KW - Crashes KW - Highway bridges KW - Highway safety KW - Loss and damage KW - Marine safety KW - Towboats KW - Transportation safety KW - Water transportation crashes UR - https://trid.trb.org/view/410703 ER - TY - RPRT AN - 00664298 AU - National Transportation Safety Board TI - HIGHWAY-MARINE ACCIDENT REPORT: U.S. TOWBOAT CHRIS COLLISION WITH THE JUDGE WILLIAM SEEBER BRIDGE, NEW ORLEANS, LOUISIANA, MAY 28, 1993 PY - 1994/06/07 SP - 59 p. AB - On May 28, 1993, a towboat and an empty hopper barge collided with a support pier of the Judge William Seeber Bridge, which spans the Inner Harbor Navigation Canal in New Orleans, Louisiana. About 150 feet of the four-lane bridge deck collapsed onto the barge and into the shallow waters of the canal. Two automobiles fell with the bridge deck. One passenger died, and two others were seriously injured. The safety issues discussed in this report include the adequacy of operator performance, the timeliness of toxicological testing, and the vulnerability of this bridge and of bridges nationwide to vessel collision and collapse. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the Federal Highway Administration, the U.S. Coast Guard, the U.S. Army Corps of Engineers, the Louisiana Department of Transportation and Development, the American Association of State Highway and Transportation Officials, and the Board of Commissioners of the Port of New Orleans. KW - Barges KW - Bridge piers KW - Collapse KW - Crashes KW - Drug tests KW - Fatalities KW - Highway bridges KW - Injuries KW - Operator performance KW - Personnel performance KW - Recommendations KW - Towboats KW - Vulnerability UR - https://trid.trb.org/view/405180 ER - TY - RPRT AN - 00664261 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CONTROLLED COLLISION WITH TERRAIN, EXPRESS II AIRLINES, INC./NORTHWEST AIRLINK FLIGHT 5719, JETSTREAM BA-3100, N334PX, HIBBING, MINNESOTA, DECEMBER 1, 1993 PY - 1994/05/24 SP - 114 p. AB - This report explains the crash of Northwest Airlink flight 5719, a Jetstream BA-3100, while the airplane was on the localizer back course approach to runway 13 at Chisholm-Hibbing Airport, Hibbing, Minnesota, on December 1, 1993. The safety issues in the report focused on pilot training and procedures, company oversight of flight operations, and surveillance by the Federal Aviation Administration. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Airline pilots KW - Fatalities KW - Oversight KW - Personnel performance KW - Pilot performance KW - Surveillance KW - U.S. Federal Aviation Administration UR - https://trid.trb.org/view/405144 ER - TY - RPRT AN - 00664262 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNCONTROLLED COLLISION WITH TERRAIN, AMERICAN INTERNATIONAL AIRWAYS FLIGHT 808, DOUGLAS DC-8-61, N814CK, U.S. NAVAL AIR STATION, GUANTANAMO BAY, CUBA, AUGUST 18, 1993 PY - 1994/05/10 SP - 150 p. AB - This report explains the crash of American International Airways Flight 808, a DC-8-61, about 1/4 mile from the approach end of runway 10 at Leeward Point Airfield, U.S. Naval Air Station, Guantanamo Bay, Cuba, on August 18, 1993. The safety issues discussed in the report include flightcrew scheduling, the effects of fatigue on flightcrew performance, training on special airports, and the dissemination of information about special airports. Safety recommendations concerning these issues were made to the Federal Aviation Administration, American International Airways, Inc., and the Department of Defense. KW - Air transportation crashes KW - Fatigue (Physiological condition) KW - Fires KW - Flight crews KW - Injuries KW - Performance KW - Special airports KW - Training KW - Types of airports UR - https://trid.trb.org/view/405145 ER - TY - RPRT AN - 00669092 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD HIGHWAY ACCIDENT REPORT: TRACTOR-SEMITRAILER COLLISION WITH BRIDGE COLUMNS ON INTERSTATE 65, EVERGREEN, ALABAMA, MAY 19, 1993 PY - 1994/04/21 SP - 39 p. AB - On May 19, 1993, a tractor with bulk-cement-tank semitrailer was traveling south on Interstate 65 near Evergreen, Alabama, and collided with a supporting bridge column on the County Road 22 overpass. Two spans of the overpass collapsed onto the semitrailer and the southbound lanes of the interstate. An automobile and a tractor-semitrailer then collided with the collapsed bridge spans. The cement-tank truck driver was seriously injured; the drivers of the other vehicles were killed. The safety issues discussed in the report are the truck driver's possibly falling asleep, marijuana use, and the identification and evaluation of bridges that are vulnerable to high-speed heavy vehicle collisions and subsequent collapse. KW - Bridges KW - Crash causes KW - Crashes KW - Highway safety KW - Loss and damage KW - Tractor trailer combinations KW - Transportation safety UR - https://trid.trb.org/view/410702 ER - TY - RPRT AN - 00664256 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: TRACTOR-SEMITRAILER COLLISION WITH BRIDGE COLUMNS ON INTERSTATE 65, EVERGREEN, ALABAMA, MAY 19, 1993 PY - 1994/04/21 SP - 42 p. AB - On May 19, 1993, a tractor with bulk-cement-tank semitrailer was traveling south on Interstate 65 near Evergreen, Alabama, and collided with a supporting bridge column of the County Road 22 overpass. Two spans of the overpass collapsed onto the semitrailer and the southbound lanes of the interstate. An automobile and a tractor-semitrailer then collided with the collapsed bridge spans. The cement-tank truck driver was seriously injured; the drivers of the other vehicles were killed. The safety issues discussed in this report are the truck driver's possibly falling asleep, marijuana use, and the identification and evaluation of bridges that are vulnerable to high-speed heavy-vehicle collisions and subsequent collapse. As a result of its investigation, the National Transportation Safety Board issued safety recommendations to the Federal Highway Administration and the American Association of State Highway Transportation Officials. KW - Bridge substructures KW - Collapse KW - Columns KW - Crash investigation KW - Crashes KW - Driving KW - Falling asleep at the wheel KW - Fatalities KW - Fatigue (Physiological condition) KW - Heavy vehicles KW - High speed ground transportation KW - High speed vehicles KW - Highway bridges KW - Highway safety KW - Injuries KW - Interstate Highway System KW - Marijuana KW - Recommendations KW - Sleep deprivation KW - Speed KW - Tractor trailer combinations KW - Traffic crashes KW - Truck drivers KW - Vulnerability UR - https://trid.trb.org/view/405139 ER - TY - RPRT AN - 00664257 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENTS DATA, U.S. AIR CARRIER OPERATIONS, CALENDAR YEAR 1991 PY - 1994/04/15 SP - 73 p. AB - This publication presents the record of aviation accidents involving revenue operations of U.S. Air Carriers including Commuter Air Carriers and On Demand Air Taxis for calendar year 1991. The report is divided into three major sections according to the federal regulations under which the flight was conducted - 14 CFR 121, 125, 127, Scheduled 14 CFR 135, or Nonscheduled 14 CFR 135. In each section of the report tables are presented to describe the losses and characteristics of 1991 accidents to enable comparison with prior years. KW - Air taxi service KW - Air transportation crashes KW - Aircraft KW - Aircraft damage KW - Airlines KW - Commuter airlines KW - Crash causes KW - Crash rates KW - Fatalities KW - Fires KW - Injuries KW - Midair crashes KW - Tables (Data) UR - https://trid.trb.org/view/405140 ER - TY - RPRT AN - 00669091 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD ACCIDENT REPORT: CONTROLLED FLIGHT INTO TERRAIN, FEDERAL AVIATION ADMINISTRATION BEECH SUPER KING AIR 300/F, N82, FRONT ROYAL, VIRGINIA, OCTOBER 26, 1993 PY - 1994/04/12 SP - 110 p. AB - This report explains the crash into mountainous terrain of a Beech Super King Air 300/F, N82, owned by the Federal Aviation Administration, near Front Royal, Virginia, on October 26, 1993. The safety issues discussed in the report focused on the Federal Aviation Administration's flying program operations and the flight safety management system. Recommendations concerning these issues were addressed to the Federal Aviation Administration. KW - Aviation safety KW - Crash injury research KW - Crash reports KW - Transportation safety UR - https://trid.trb.org/view/410701 ER - TY - RPRT AN - 00664260 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CONTROLLED FLIGHT INTO TERRAIN, FEDERAL AVIATION ADMINISTRATION, BEECH SUPER KING AIR 300/F, N82, FRONT ROYAL, VIRGINIA, OCTOBER 26, 1993 PY - 1994/04/12 SP - 111 p. AB - This report explains the crash into mountainous terrain of a Beech Super King Air 300/F, N82, owned by the Federal Aviation Administration, near Front Royal, Virginia, on October 26, 1993. The safety issues discussed in the report focused on the Federal Aviation Administration's flying program operations and the flight safety management system. Recommendations concerning these issues were addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Airline pilots KW - Aviation safety KW - Fatalities KW - Fog KW - Mountains KW - Personnel performance KW - Pilot performance UR - https://trid.trb.org/view/405143 ER - TY - RPRT AN - 00669164 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA. U.S. GENERAL AVIATION CALENDAR YEAR 1991 PY - 1994/04/04 SP - 87 p. AB - The report presents a statistical compilation and review of general aviation accidents which occurred in 1991 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving U.S. registered aircraft not conducting operations under 14 CFR 121, 14 CFR 125, 14 CFR 127, or 14 CFR 135. The report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents; and, Midair Collision Accidents. Several tables present accident parameters for 1991 accidents only, and each section includes tabulations which present comparative statistics for 1991 and for the five-year period 1986-1990. KW - Air transportation crashes KW - Crash data KW - Crash investigation KW - Crash types KW - Crashes KW - Fatalities KW - Statistics UR - https://trid.trb.org/view/410743 ER - TY - RPRT AN - 00664258 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA, U.S. GENERAL AVIATION, CALENDAR YEAR 1991 PY - 1994/04/04 SP - 85 p. AB - This report presents a statistical compilation and review of general aviation accidents which occurred in 1991 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving U.S. registered aircraft not conducting operations under 14 CFR 121, 14 CFR 125, 14 CFR 127, or 14 CFR 135. This report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents; and Midair Collision Accidents. Several tables present accident parameters for 1991 accidents only, and each section includes tabulations which present comparative statistics for 1991 and the for the five-year period 1986-1990. KW - Air transportation crashes KW - Aircraft KW - Aircraft damage KW - Crash causes KW - Crash rates KW - Fatalities KW - Fires KW - General aviation KW - Injuries KW - Midair crashes KW - Tables (Data) UR - https://trid.trb.org/view/405141 ER - TY - RPRT AN - 00647354 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT/INCIDENT SUMMARY REPORT: IN-FLIGHT LOSS OF CONTROL, LEADING TO FORCED LANDING AND RUNWAY OVERRUN, CONTINENTAL EXPRESS, INC., N24706, EMBRAER EMB-120 RT, PINE BLUFF, ARKANSAS, APRIL 29, 1993 PY - 1994/03/15 SP - 51 p. AB - This report explains the in-flight loss of control of N24706, leading to a forced landing and runway overrun at Pine Bluff, Arkansas, on April 29, 1993. The safety issues discussed in the report are flightcrew professionalism, inattentiveness, and fatigue. A recommendation concerning fatigue was made to the Federal Aviation Administration. KW - Air transportation crashes KW - Alertness KW - Attention KW - Crash investigation KW - Fatigue (Physiological condition) KW - Flight crews KW - Forced aircraft landings KW - Landing KW - Loss of control KW - Loss of control accidents KW - Professional personnel KW - Professionalism KW - Recommendations KW - Runway overruns UR - https://trid.trb.org/view/387173 ER - TY - RPRT AN - 00669089 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD HAZARDOUS MATERIALS ACCIDENT REPORT: DERAILMENT OF BURLINGTON NORTHERN FREIGHT TRAIN NO. 01-142-30 AND RELEASE OF HAZARDOUS MATERIALS IN THE TOWN OF SUPERIOR, WISCONSIN, JUNE 30, 1992 PY - 1994/03 SP - 101 p. AB - The report explains the derailment of Burlington Northern Railroad freight train in the Town of Superior, Wisconsin, on June 30, 1992, and subsequent release of aromatic concentrates into the Nemadji River. The more volatile constituents of the aromatic concentrates evaporated from the surface of the river and formed a vapor cloud about 200 miles long and 5 miles wide resulting in the evacuation of more than 40,000 people from the Town and City of Superior, the City of Duluth, Minnesota, and surrounding areas. The safety issues discussed in the report are: 1) the adequacy of the Federal Railroad Administration track safety standards for rail-head surface conditions; 2) the lack of objective criteria by which to identify or to define rail-head surface conditions; 3) the adequacy of internal inspection methods for rail with severe shelling or other significant surface conditions; 4) the accident performance of the tank cars, and 5) the release of the aromatic concentrates and the consequences of the release. KW - Crash reports KW - Derailments KW - Freight trains KW - Hazardous materials KW - Hazardous materials transportation KW - Safety KW - Safety standards KW - Standards KW - Transportation KW - Transportation safety UR - https://trid.trb.org/view/410699 ER - TY - RPRT AN - 00669087 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD HIGHWAY ACCIDENT REPORT: GASOLINE TANK TRUCK/AMTRAK TRAIN COLLISION AND FIRE IN FORT LAUDERDALE, FLORIDA, MARCH 17, 1993 PY - 1994/02/15 SP - 23 p. AB - An Amerada Hess tractor-semitrailer hauling gasoline was struck by National Railroad Passenger Corporation (Amtrak) Train 91 on March 17, 1993. The truckdriver was attempting to cross a railroad/highway grade crossing on Cypress Creek Road in Fort Lauderdale, Florida. Traffic in the area of the crossing was congested because the left and center lanes were closed just over the crossing. Traffic was being channeled into the right lane and later shifted into a right-turn lane. The truck, which was loaded with 8,500 gallons of gasoline, was punctured when it was struck. A fire erupted, engulfing the truck and nine other vehicles. The fire killed the truckdriver and five occupants of three stopped vehicles. The major safety issues discussed in the report are the performance of the truckdriver and traffic control in work zones near railroad/highway grade crossings. KW - Fire hazards KW - Fires KW - Grade crossing accidents KW - Hazards KW - Railroad grade crossings KW - Tank trucks KW - Tractor trailer combinations KW - Traffic crashes KW - Transportation safety UR - https://trid.trb.org/view/410697 ER - TY - RPRT AN - 00647352 AU - National Transportation Safety Board TI - AIRCRAFT INCIDENT REPORT: IN-FLIGHT TURBULENCE ENCOUNTER AND LOSS OF PORTIONS OF THE ELEVATORS, CHINA AIRLINES FLIGHT CI-012, MCDONNELL DOUGLAS MD-11-P, TAIWAN REGISTRATION B-150, ABOUT 20 MILES EAST OF JAPAN, DECEMBER 7, 1992 PY - 1994/02/15 SP - 60 p. AB - This report explains the in-flight turbulence encounter of China Airlines flight CI-012, an MD-11 airplane, which subsequently departed controlled flight and sustained damage to the outboard elevators, portions of which separated from the airplane, on December 7, 1992, about 20 miles east of Japan. The safety issues discussed in the report include the design and certification of the MD-11. Safety recommendations concerning KW - Air transportation crashes KW - Aircraft KW - Aircraft design KW - Airworthiness KW - Certification KW - Crash investigation KW - Damages KW - In-flight turbulence KW - Loss and damage KW - McDonnell Douglas MD-11 KW - Outboard elevators KW - Recommendations KW - Vehicle design UR - https://trid.trb.org/view/387171 ER - TY - RPRT AN - 00647355 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: GASOLINE TANK TRUCK/AMTRAK TRAIN COLLISION AND FIRE IN FORT LAUDERDALE, FLORIDA, MARCH 17, 1993 PY - 1994/02/15 SP - 24 p. AB - An Amerada Hess tractor-semitrailer hauling gasoline was struck by National Railroad Passenger Corporation (Amtrak) Train 91 on March 17, 1993. The truck driver was attempting to cross a railroad/highway grade crossing on Cypress Creek Road in Fort Lauderdale, Florida. Traffic in the area of the crossing was congested because the left and center lanes were closed just over the crossing. Traffic was being channeled into the right lane and later shifted into a right-turn lane. The truck, which was loaded with 8,500 gallons of gasoline, was punctured when it was struck. A fire erupted, engulfing the truck and nine other vehicles. The fire killed the truck driver and five occupants of three stopped vehicles. The major safety issues discussed in this report are the performance of the truck driver and traffic control in work zones near railroad/highway grade crossings. As a result of its investigation of this accident, the National Transportation Safety Board makes recommendations to the Federal Highway Administration, the American Trucking Association, Inc., and the Amerada Hess Corporation. KW - Amtrak KW - Fatalities KW - Fires KW - Fort Lauderdale (Florida) KW - Gasoline KW - Lane closing KW - Lane closure KW - Personnel performance KW - Railroad grade crossings KW - Recommendations KW - Tractor trailer combinations KW - Traffic congestion KW - Truck drivers KW - Work zone traffic control UR - https://trid.trb.org/view/387174 ER - TY - RPRT AN - 00669088 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD AIRCRAFT ACCIDENT REPORT: RUNWAY DEPARTURE FOLLOWING LANDING, AMERICAN AIRLINES FLIGHT 102, MCDONNELL DOUGLAS DC-10-30, N139AA, DALLAS/FORT WORTH INTERNATIONAL AIRPORT, TEXAS, APRIL 14, 1993 PY - 1994/02/14 SP - 175 p. AB - This report explains the runway departure of American Airlines flight 102, a DC-10-30, after landing at Dallas/Fort Worth International Airport, Texas, on April 14, 1993. The safety issues discussed in the report include weather conditions affecting the flight, flightcrew and air traffic control training and procedures, airplane emergency evacuation, lighting, and runway maintenance. Recommendations concerning these issues were made to the Federal Aviation Administration, Dallas/Fort Worth International Airport, and American Airlines, Inc. KW - Air transportation crashes KW - Airport runways KW - Aviation safety KW - Crash causes KW - Crash reports KW - Transportation safety UR - https://trid.trb.org/view/410698 ER - TY - RPRT AN - 00647351 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: RUNWAY DEPARTURE FOLLOWING LANDING, AMERICAN AIRLINES FLIGHT 102, MCDONNELL DOUGLAS DC-10-30, N139AA, DALLAS/FORT WORTH INTERNATIONAL AIRPORT, TEXAS, APRIL 14, 1993 PY - 1994/02/14 SP - 175 p. AB - This report explains the runway departure of American Airlines flight 102, a DC-10-30, after landing at Dallas/Fort Worth International Airport, Texas, on April 14, 1993. The safety issues discussed in the report include weather conditions affecting the flight, flightcrew and air traffic control training and procedures, airplane emergency evacuation lighting, and runway maintenance. Recommendations concerning these issues were made to the Federal Aviation Administration, Dallas/Fort Worth International Airport, and American Airlines, Inc. KW - Air traffic controllers KW - Air transportation crashes KW - Aircraft landings KW - Airport runways KW - Crash investigation KW - Disasters and emergency operations KW - Emergency procedures KW - Evacuation KW - Flight crews KW - Landing KW - Lighting KW - Recommendations KW - Runway overruns KW - Thunderstorms KW - Training UR - https://trid.trb.org/view/387170 ER - TY - RPRT AN - 00669090 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SPECIAL INVESTIGATION REPORT: SAFETY ISSUES RELATED TO WAKE VORTEX ENCOUNTERS DURING VISUAL APPROACH TO LANDING PY - 1994/02 SP - 101 p. AB - Since December 1992 there have been five accidents and incidents in which an airplane on approach to landing encountered the wake vortex of a preceding Boeing 757 (R-757). 13 occupants died in the two accidents. The encounters, which occurred during visual conditions, were severe enough to create an unrecoverable loss of control for a Cessna Citation, a Cessna 182, and an Israel Aircraft Industries Westwind. Additionally, there were significant but recoverable losses of control for a McDonnell Douglas MD-88 and a B-737 (both required immediate and aggressive flightcontrol deflections by their flightcrews). The Safety Board conducted a special investigation to examine in detail the circumstances surrounding the five recent accidents and incidents in which an airplane on approach to landing encountered the wake vortex of a preceding B-757. The purpose of the Safety Board's special investigation was to determine what improvements may be needed in existing procedures to reduce the likelihood of wake vortex encounters. KW - Aircraft landings KW - Aviation safety KW - Crash reports KW - Flight control systems KW - Landing KW - Landing aids KW - Transportation safety KW - Wakes UR - https://trid.trb.org/view/410700 ER - TY - RPRT AN - 00647348 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT: SAFETY ISSUES RELATED TO WAKE VORTEX ENCOUNTERS DURING VISUAL APPROACH TO LANDING PY - 1994/02 SP - 101 p. AB - The National Transportation Safety Board conducted a special investigation to examine in detail the circumstances surrounding five recent accidents and incidents in which an airplane on approach to landing encountered the wake vortex of a preceding Boeing 757. Thirteen occupants died in two of the accidents. The encounters, which occurred during visual conditions, were severe enough to create an unrecoverable loss of control for a Cessna Citation, a Cessna 182, and an Israel Aircraft Industries Westwind. Additionally, there were significant but recoverable losses of control for a McDonnell Douglas MD-88 and Boeing 737 (both required immediate and aggressive flight control deflections by their flightcrews). The safety issues discussed in this special investigation report are: the adequacy of the current aircraft weight classification scheme to establish separation criteria to avoid wake vortex encounters, the adequacy of air traffic control procedures related to visual approaches and visual flight rules operations behind heavier airplanes, pilot knowledge related to the avoidance of wake vortices, and the lack of available data to analyze the history of wake vortex encounters in the United States. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air traffic control KW - Air transportation crashes KW - Crash investigation KW - Data needs KW - Fatalities KW - Information organization KW - Loss of control KW - Loss of control accidents KW - Pilot knowledge KW - Recommendations KW - Visual flight KW - Visual flight rules KW - Wakes UR - https://trid.trb.org/view/387167 ER - TY - RPRT AN - 00669084 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD AIRCRAFT ACCIDENT/INCIDENT SUMMARY REPORT: CONTROLLED FLIGHT INTO TERRAIN GP EXPRESS AIRLINES, INC., N115GP, BEECHCRAFT C-99, SHELTON, NEBRASKA, APRIL 28, 1993 PY - 1994/01/19 SP - 67 p. AB - The report explains the crash of N115GP into terrain at Shelton, Nebraska. The safety issues discussed include attempted aerobatic maneuvers in commercial aircraft, check flight among peers, management responsibility to instill commitment of flight safety, and Federal Aviation Administration oversight of 14 CFR Part 135 operations. KW - Air transportation crashes KW - Civil aircraft KW - Crash investigation KW - Crash reports KW - Incidents KW - Traffic incidents KW - Transportation safety UR - https://trid.trb.org/view/410694 ER - TY - RPRT AN - 00647353 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT/INCIDENT SUMMARY REPORT: CONTROLLED FLIGHT INTO TERRAIN, GP EXPRESS AIRLINES, INC., N115GP, BEECHCRAFT C-99, SHELTON, NEBRASKA, APRIL 28, 1993 PY - 1994/01/19 SP - 66 p. AB - This report explains the crash of N115GP into terrain at Shelton, Nebraska. The safety issues discussed include attempted aerobatic maneuvers in commercial aircraft, check flights among peers, management responsibility to instill commitment of flight safety, and Federal Aviation Administration oversight of 14 CFR Part 135 operations. KW - 14 Cfr part 135 KW - Aerobatic maneuvers KW - Air transportation crashes KW - Aviation safety KW - Check flights KW - Crash investigation KW - Oversight KW - U.S. Federal Aviation Administration UR - https://trid.trb.org/view/387172 ER - TY - RPRT AN - 00669086 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD SAFETY STUDY: A REVIEW OF FLIGHTCREW-INVOLVED, MAJOR ACCIDENTS OF U.S. AIR CARRIERS, 1978 THROUGH 1990 PY - 1994/01 SP - 111 p. AB - Recognizing that deficiencies in various aspects of the aviation system may underlie the errors made by flightcrews, the Safety Board conducted this study to learn more about flightcrew performance by evaluating the characteristics of the operating environments, the flightcrews, and errors made in major accidents of U.S. air carriers between 1978 and 1990 in which the flightcrew was cited by the Board. It also describes the methodology of the study and explains the measures of operational context, flightcrew characteristics, and errors in flightcrew performance; the broad, operational context within which flightcrew-involved accidents occurred; the characteristics of the flightcrews; specific errors made by the flightcrews and their association with the circumstances of the accidents and characteristics of the flightcrews; and the Safety Board's findings and safety recommendations made as a result of the study. KW - Aviation safety KW - Crash causes KW - Crash investigation KW - Error analysis KW - Flight crews KW - Operator performance KW - Personnel performance KW - Transportation safety UR - https://trid.trb.org/view/410696 ER - TY - RPRT AN - 00647349 AU - National Transportation Safety Board TI - SAFETY STUDY: A REVIEW OF FLIGHTCREW-INVOLVED, MAJOR ACCIDENTS OF U.S. AIR CARRIERS, 1978 THROUGH 1990 PY - 1994/01 SP - 110 p. AB - U.S. air carrier operations are extremely safe, and the accident rate has declined in recent years. However, among the wide array of factors cited by the National Transportation Safety Board (NTSB) as causal or contributing to airplane accidents, actions or inactions by the flightcrew have been cited in the majority of fatal air carrier accidents. Recognizing that deficiencies in various aspects of the aviation system may adversely influence flightcrew performance, the NTSB conducted this study to learn more about flightcrew performance by evaluating characteristics of the operating environment, crewmembers, and errors made in major accidents of U.S. air carriers between 1978 and 1990 in which the flightcrew was cited by the NTSB. Characteristics of the operating environments and flightcrews were identified from information derived from major investigations of 36 accidents and 1 incident. The errors identified were evaluated in light of the contexts in which they occurred. The safety issues discussed in the report are (a) performance of flightcrews when the captain is flying pilot and the first officer is the non-flying pilot; (b) performance of the non-flying pilot in monitoring and challenging errors made by the flying pilot; (c) adequacy and error-tolerance of checklist procedures during the taxi phase of operation; (d) associations between flightcrew performance and crewmember experience, crewmembers' familiarity with each other, work/rest issues, and flight delays; and (d) adequacy of crew resource management training programs. Safety recommendations concerning flightcrew training and flight operations procedures were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Characteristics KW - Crash investigation KW - Errors KW - Flight crews KW - Operating environment KW - Performance KW - Recommendations KW - Training UR - https://trid.trb.org/view/387168 ER - TY - RPRT AN - 00852851 AU - National Transportation Safety Board TI - AMTRAK TRAIN 87 DERAILMENT AFTER COLLIDING WITH INTERMODAL TRAILER FROM CSXT TRAIN 176, SELMA, NORTH CAROLINA, MAY 16, 1994: RAILROAD ACCIDENT REPORT. PY - 1994 IS - PB95-916302 AB - No abstract provided. KW - Piggyback transportation KW - Railroad crashes KW - Railroads KW - Selma UR - https://trid.trb.org/view/550659 ER - TY - RPRT AN - 00860631 AU - National Transportation Safety Board TI - U.S. TOWBOAT CHRIS COLLISION WITH THE JUDGE WILLIAM SEEBER BRIDGE, NEW ORLEANS, LOUISIANA, MAY 28, 1993: HIGHWAY-MARINE ACCIDENT REPORT. PY - 1994 IS - NTSB/HAR-94/03 AB - No abstract provided. KW - Bridges KW - Marine safety KW - New Orleans (Louisiana) KW - Towboats KW - Water transportation crashes UR - https://trid.trb.org/view/523063 ER - TY - RPRT AN - 00854405 AU - National Transportation Safety Board TI - MARINE ACCIDENT REPORT EXPLOSION AND FIRE ON BOARD THE U.S. TANKSHIP OMI CHARGER, GALVESTON, TEXAS, OCTOBER 9, 1993. PY - 1994 IS - PB94-916404 AB - No abstract provided. KW - Fires KW - Galveston (Texas) KW - Marine safety KW - Ships KW - Tankers KW - Water transportation crashes UR - https://trid.trb.org/view/520952 ER - TY - RPRT AN - 00851860 AU - National Transportation Safety Board TI - STALL AND LOSS OF CONTROL ON FINAL APPROACH, ATLANTIC COAST AIRLINES, INC./UNITED EXPRESS FLIGHT 6291, JETSTREAM 4101, N304UE, COLUMBUS, OHIO, JANUARY 7, 1994. PY - 1994 IS - PB94-910409 AB - No abstract provided. KW - Aerodynamics KW - Air transportation crashes KW - Airplanes KW - Columbus (Ohio) KW - Stall UR - https://trid.trb.org/view/550419 ER - TY - RPRT AN - 00851681 AU - National Transportation Safety Board TI - COMMUTER AIRLINE SAFETY: SAFETY STUDY. PY - 1994 IS - PB94-917004 AB - No abstract provided. KW - Air transportation KW - Air transportation crashes KW - Local service airlines KW - United States UR - https://trid.trb.org/view/550402 ER - TY - RPRT AN - 00849912 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: HEAD-ON COLLISION AND DERAILMENT OF BURLINGTON NORTHERN FREIGHT TRAIN WITH UNION PACIFIC FREIGHT TRAIN, KELSO, WASHINGTON, NOVEMBER 11, 1993. PY - 1994 IS - PB94-916302 AB - No abstract provided. KW - Kelso (Washington) KW - Railroad crashes KW - Railroads UR - https://trid.trb.org/view/550368 ER - TY - RPRT AN - 00849389 AU - National Transportation Safety Board AU - Amtrak TI - RAILROAD-MARINE ACCIDENT REPORT: DERAILMENT OF AMTRAK TRAIN NO. 2 ON THE CSXT BIG BAYOU CANOT BRIDGE NEAR MOBILE, ALABAMA, SEPTEMBER 22, 1993. PY - 1994 IS - PB94-916301 AB - No abstract provided. KW - Inland water transportation KW - Mobile (Alabama) KW - Portable equipment KW - Railroad crashes KW - Sunset limited (Express train) KW - Sunset Limited (Train) UR - https://trid.trb.org/view/550175 ER - TY - RPRT AN - 00842836 AU - National Transportation Safety Board TI - DERAILMENT OF BURLINGTON NORTHERN FREIGHT TRAIN NO. 01-142-30 AND RELEASE OF HAZARDOUS MATERIALS IN THE TOWN OF SUPERIOR, WISCONSIN, JUNE 30, 1992. PY - 1994 IS - NTSB/HZM-94/01 AB - No abstract provided. KW - Crashes KW - Hazardous materials KW - Railroad crashes KW - Superior (Wisconsin) KW - Transportation UR - https://trid.trb.org/view/544352 ER - TY - RPRT AN - 00647374 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT CASES: AUTOMATIC RESTRAINTS, SEPTEMBER 1990 - MAY 1992 PY - 1994 SP - 116 p. AB - National Transportation Safety Board personnel from the regional offices investigated 56 crashes involving passenger cars equipped with automatic restraints (air bags and automatic belt systems). All crashes included in the study occurred during the period September 1990 through May 1992. Case selection was based on timely notification of the crash and on the availability of investigators and pertinent evidence. The study focuses on the automatic systems and on the concurrent use or nonuse of available belt systems. Crash causes are not addressed, and no safety recommendations are made. KW - Air bags KW - Automatic restraints KW - Automatic seat belts KW - Case studies KW - Crash investigation KW - Traffic crashes UR - https://trid.trb.org/view/387186 ER - TY - RPRT AN - 00643524 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. GENERAL AVIATION, CALENDAR YEAR 1990 PY - 1993/12/17 SP - 82 p. AB - This report presents a statistical compilation and review of general aviation accidents which occurred in 1990 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving U.S. registered aircraft not conducting operations under 14 CFR 121, 14 CFR 125, 14 CFR 127, or 14 CFR 135. This report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents; and Midair Collision Accidents. Several tables present accident parameters for 1990 accidents only, and each section includes tabulations which present comparative statistics for 1990 and for the five-year period 1985-1989. KW - Air transportation crashes KW - Annual reviews KW - Crash data KW - Fatalities KW - General aviation KW - Injuries KW - Loss and damage KW - Midair crashes KW - Property KW - Property damage KW - Statistics KW - Tables (Data) UR - https://trid.trb.org/view/386017 ER - TY - RPRT AN - 00669085 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD AIRCRAFT ACCIDENT REPORT: IN-FLIGHT LOSS OF PROPELLER BLADE AND UNCONTROLLED COLLISION WITH TERRAIN, MITSUBISHI MU-2B-60, N86SD, ZWINGLE, IOWA, APRIL 19, 1993 PY - 1993/11/16 SP - 131 p. AB - The report explains the in-flight loss of propeller blade and subsequent crash of an MU-2B-60 airplane, operated by the South Dakota Department of Transportation, while the flightcrew was attempting an approach to an emergency landing at Dubuque Regional Airport, Dubuque, Iowa, on April 19, 1993. The National Transportation Safety Board determines that the probable cause of the accident was the fatigue cracking and fracture of the propeller hub arm. The safety issues in the report include the propeller hub design, certification and continuing airworthiness, and air traffic control training. Safety recommendations concerning these issues were addressed to the Federal Aviation Administration. KW - Aircraft landings KW - Aviation safety KW - Crash causes KW - Disasters and emergency operations KW - Emergency procedures KW - Flight KW - Inflight KW - Landing KW - Safety KW - Safety standards KW - Standards KW - Transportation safety UR - https://trid.trb.org/view/410695 ER - TY - RPRT AN - 00647350 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT LOSS OF PROPELLER BLADE AND UNCONTROLLED COLLISION WITH TERRAIN, MITSUBISHI MU-2B-60, N86SD, ZWINGLE, IOWA, APRIL 19, 1993 PY - 1993/11/16 SP - 130 p. AB - This report explains the in-flight loss of propeller blade and subsequent crash of an MU-2B-60 airplane, operated by the South Dakota Department of Transportation, while the flightcrew was attempting an approach to an emergency landing at Dubuque Regional Airport, Dubuque, Iowa, on April 19, 1993. The safety issues discussed in the report include the propeller hub design, certification and continuing airworthiness, and air traffic control training. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Aerospace industry KW - Air traffic controllers KW - Air transportation crashes KW - Aircraft KW - Aircraft certification KW - Airworthiness KW - Certification KW - Crash investigation KW - Crash landing KW - Emergency airstrips KW - Emergency landings KW - Loss and damage KW - Loss of propeller blade KW - Propeller blades KW - Propeller hub design KW - Recommendations KW - Training UR - https://trid.trb.org/view/387169 ER - TY - RPRT AN - 00667366 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD PIPELINE ACCIDENT REPORT: HIGHLY VOLATILE LIQUIDS RELEASE FROM UNDERGROUND STORAGE CAVERN AND EXPLOSION, MAPCO NATURAL GAS LIQUIDS, INC., BRENHAM, TEXAS, APRIL 7, 1992 PY - 1993/11/04 SP - 115 p. AB - The report explains how highly volatile liquid products escaped from an underground storage cavern and formed a vapor cloud that exploded, killing three people and damaging almost all buildings within 3 square miles of the storage facility. From its investigation of this accident, the Safety Board identified safety issues in the following areas: safety control systems, cavern management procedures, employee and management performance, emergency preparedness, and Federal and State safety requirements and oversight for underground storage and related pipelines. KW - Caverns KW - Disaster preparedness KW - Disasters and emergency operations KW - Explosive vapor ignition KW - Handling and storage KW - Pipeline safety KW - Safety factors KW - Underground storage KW - Vapor cloud explosions UR - https://trid.trb.org/view/406323 ER - TY - RPRT AN - 00643527 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: INADVERTENT IN-FLIGHT SLAT DEPLOYMENT, CHINA EASTERN AIRLINES FLIGHT 583, MCDONNELL DOUGLAS MD-11, B-2171, 950 NAUTICAL MILES SOUTH OF SHEMYA, ALASKA, APRIL 6, 1993 PY - 1993/10/27 SP - 73 p. AB - This report explains the inadvertent deployment of the MD-11 airplane's leading edge wing slats while the airplane was in cruise flight, about 950 nautical miles south of Shemya, Alaska, on April 6, 1993. Safety issues in the report focused on the inadequate design of the flap/slat actuation handle, the inadvertent extension of the leading edge wing slats, the longitudinal stability of the airplane during the pitch upset, the pilot-induced oscillations that can occur during recovery, the premature deterioration of the seat cushion fire-blocking material, and the inability of the material to provide the required seat cushion fire protection on transport-category airplanes. Safety recommendations on these issues were made to the Federal Aviation Administration. KW - Air transportation crashes KW - Crash reports KW - Deterioration KW - Fire resistant materials KW - Flap/slat actuation handle design KW - Inadvertent in-flight slat deployment KW - McDonnell Douglas aircraft KW - McDonnell Douglas MD-11 KW - Oscillation KW - Recommendations KW - Seat cushions KW - Seats KW - Stability (Mechanics) UR - https://trid.trb.org/view/386020 ER - TY - RPRT AN - 00667272 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD AIRCRAFT ACCIDENT REPORT: IN-FLIGHT ENGINE SEPARATION, JAPAN AIRLINES, INC., FLIGHT 46E, BOEING 747-121, N473EV, ANCHORAGE, ALASKA, MARCH 31, 1993 PY - 1993/10/13 SP - 110 p. AB - The report explains the in-flight separation of the No. 2 engine and engine pylon from a B-747-121 airplane shortly after its takeoff from Anchorage International Airport, Anchorage, Alaska, on March 31, 1993. The safety issues discussed in the report focused on the inspection of B-747 engine pylons, meteorological hazards to aircraft, the lateral load-carrying capability of engine pylon structures, and aircraft departure routes at Anchorage International Airport during turbulent weather conditions. KW - Air transportation crashes KW - Aircraft KW - Aircraft engines KW - Aircraft safety KW - Aviation safety KW - Crash investigation KW - Engines KW - Flight KW - Inflight KW - Inspection KW - Inspection records KW - Lateral loads KW - Load carrying capacity KW - Load limits KW - Meteorological data KW - Meteorological phenomena UR - https://trid.trb.org/view/406271 ER - TY - RPRT AN - 00643526 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: IN-FLIGHT ENGINE SEPARATION, JAPAN AIRLINES, INC., FLIGHT 46E, BOEING 747-121, N473EV, ANCHORAGE, ALASKA, MARCH 31, 1993 PY - 1993/10/13 SP - 109 p. AB - This report explains the in-flight separation of the No. 2 engine and engine pylon from a B-747-121 airplane shortly after its takeoff from Anchorage International Airport, Anchorage, Alaska, on March 31, 1993. The safety issues discussed in the report focused on the inspection of B-747 engine pylons, meteorological hazards to aircraft, the lateral load-carrying capability of engine pylon structures, and aircraft departure routes at Anchorage International Airport during turbulent weather conditions. Safety recommendations concerning these issues were addressed to the Federal Aviation Administration and the National Weather Service. KW - Air transportation crashes KW - Aircraft safety KW - Aviation safety KW - Boeing 747 aircraft KW - Crash reports KW - Engine pylons KW - Engines KW - Hazards KW - In-flight engine separation KW - Inspection KW - Load carrying capacity KW - Load limits KW - Meteorological hazards KW - Pylons KW - Recommendations KW - Takeoff KW - Turbulent weather conditions KW - Weather UR - https://trid.trb.org/view/386019 ER - TY - RPRT AN - 00643523 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENTS DATA: U.S. AIR CARRIER OPERATIONS, CALENDAR YEAR 1990 PY - 1993/10/04 SP - 74 p. AB - This publication presents the record of aviation accidents involving revenue operations of U.S. Air Carriers including Commuter Air Carriers and On Demand Air Taxis for calendar year 1990. The report is divided into three major sections according to the federal regulations under which the flight was conducted - 14 CFR 121, 125, 127, Scheduled 14 CFR 135, or Nonscheduled 14 CFR 135. In each section of the report tables are presented to describe the losses and characteristics of 1990 accidents to enable comparison with prior years. KW - 14 Cfr 121 KW - 14 Cfr 125 KW - 14 Cfr 127 KW - 14 Cfr 135, scheduled KW - 14 Cfr 135, unscheduled KW - Air transportation crashes KW - Airlines KW - Annual reviews KW - Crash causes KW - Crash data KW - Crash rates KW - Fatalities KW - Injuries KW - Loss and damage KW - Losses KW - Midair crashes KW - Property KW - Property damage KW - Statistics KW - Tables (Data) KW - Weather UR - https://trid.trb.org/view/386016 ER - TY - RPRT AN - 00667273 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD AIRCRAFT ACCIDENT REPORT: MIDAIR COLLISION, MITSUBISHI MU-2B-60, N74FB, AND PIPER PA-32-301, N82419, GREENWOOD MUNICIPAL AIRPORT, GREENWOOD, INDIANA, SEPTEMBER 11, 1992 PY - 1993/09/13 SP - 85 p. AB - The report explains the midair collision of an MU-2 aircraft with a PA-32 aircraft about 2 miles northeast of the Greenwood Municipal Airport, Greenwood, Indiana, on September 11, 1992. Safety issues in the report focused on the deficiencies in the see-and-avoid concept as a primary means of collision avoidance, and the failure of pilots to fully utilize the air traffic control system by obtaining instrument flight rules clearances before takeoff. KW - Air traffic control KW - Air transportation crashes KW - Crash avoidance systems KW - Crash investigation KW - Instrument flying KW - Midair crashes UR - https://trid.trb.org/view/406272 ER - TY - RPRT AN - 00643525 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: MIDAIR COLLISION, MITSUBISHI MU-2B-60, N74FB, AND PIPER PA-32-301, N82419, GREENWOOD MUNICIPAL AIRPORT, GREENWOOD, INDIANA, SEPTEMBER 11, 1992 PY - 1993/09/13 SP - 84 p. AB - This report explains the midair collision of an MU-2 aircraft with a PA-32 aircraft about 2 miles northeast of the Greenwood Municipal Airport, Greenwood, Indiana, on September 11, 1992. Safety issues in the report focused on the deficiencies in the see-and-avoid concept as a primary means of collision avoidance, and the failure of pilots to fully utilize the air traffic control system by obtaining instrument flight rules clearances before takeoff. Recommendations concerning these issues were made to the Federal Aviation Administration, the National Business Aircraft Association, the National Association of Flight Instructors, the Experimental Aircraft Association, and the Aircraft Owners and Pilots Association. KW - Air transportation crashes KW - Airline pilots KW - Car clearances (Railroads) KW - Clearances KW - Crash avoidance systems KW - Crash reports KW - Flight training KW - Instrument flying KW - Midair crashes KW - Pilot training UR - https://trid.trb.org/view/386018 ER - TY - RPRT AN - 00666306 AU - National Transportation Safety Board TI - NATIONAL TRANSPORTATION SAFETY BOARD RAILROAD ACCIDENT/INCIDENT SUMMARY REPORT: DERAILMENT OF AMTRAK TRAIN 87, SILVER METEOR, IN PALATKA, FLORIDA, ON DECEMBER 17, 1991 PY - 1993/07/26 SP - 20 p. AB - At 11:25 a.m. on December 17, 1991, National Railroad Passenger Corporation (AMTRAK) train 87, operating on CSX Transportation Inc. (CSXT) track, derailed in Palatka, FL. As a result of the investigation of the accident, the National Transportation Safety Board identified three major safety issues: the inattentiveness of the engineer and fireman; use of prescription and over-the-counter drugs by operating crew-members; and the adequacy of Federal Railroad Administration (FRA) regulations for inspecting modern passenger car brakes. Following a brief accident narrative, the report discusses these issues, as well as the effectiveness of AMTRAK's equipment inspection and maintenance programs and the securement of food service appliances and seats in passenger cars. KW - Amtrak KW - Crash causes KW - Crash investigation KW - Derailments KW - Incident detection KW - Railroad crashes UR - https://trid.trb.org/view/405838 ER - TY - RPRT AN - 00636355 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: CHARTER BUS LOSS OF CONTROL, OVERTURN, AND FIRE, VERNON, NEW JERSEY, JULY 26, 1992 PY - 1993/06/23 SP - 87 p. AB - On July 26, 1992, the driver of a charter bus lost control of the bus as it descended a steep hill near Vernon, New Jersey. The bus struck two cars. Twelve passengers were ejected from the bus; six of them died. The safety issues discussed in the report are the deteriorated braking efficiency of the bus, the driver's handling of the gears, the adequacy of State and Federal oversight of motor carrier operations, the adequacy of the highway signs in preparing drivers to descend the hill, and the adequacy of New York State commercial vehicle inspections and safety/compliance reviews. The Safety Board made recommendations about these issues to the Federal Highway Administration, the New York Department of Motor Vehicles, the New York Department of Transportation, the American Association of Motor Vehicle Administrators, the United Bus Owners of America, and the American Bus Association. KW - Braking performance KW - Buses KW - Charter operations KW - Compliance KW - Crash investigation KW - Driving KW - Ejection KW - Fatalities KW - Handling characteristics KW - Hills KW - Injuries KW - Inspection KW - Loss of control KW - Loss of control accidents KW - Motor carriers KW - Motor vehicles KW - New York (State) KW - Oversight KW - Recommendations KW - Traffic crashes KW - Traffic signs UR - https://trid.trb.org/view/379854 ER - TY - RPRT AN - 00633463 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. AIR CARRIER OPERATIONS, CALENDAR YEAR 1989 PY - 1993/05/07 SP - 76 p. AB - This publication presents the record of aviation accidents involving revenue operations of U.S. Air Carriers including Commuter Air Carriers and On Demand Air Taxis for calendar year 1989. The report is divided into three major sections according to the federal regulations under which the flight was conducted - 14 CFR 121, 125, 127, Scheduled 14 CFR 135, or Nonscheduled 14 CFR 135. In each section of the report tables are presented to describe the losses and characteristics of 1989 accidents to enable comparison with prior years. KW - Air transportation crashes KW - Aircraft KW - Aircraft damages KW - Crash causes KW - Crash rates KW - Fatalities KW - Injuries KW - Midair crashes KW - Statistics KW - United States KW - Weather UR - https://trid.trb.org/view/374398 ER - TY - RPRT AN - 00633399 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT/INCIDENT SUMMARY REPORT: LOSS OF CONTROL, BUSINESS EXPRESS, INC., BEECHCRAFT 1900C N811BE, NEAR BLOCK ISLAND, RHODE ISLAND, DECEMBER 28, 1991 PY - 1993/04/27 SP - 77 p. AB - This report explains the crash of N811BE into the Rhode Island Sound. The safety issues discussed include the use of flight simulators rather than airplanes for training, the adequacy of FAA surveillance of Part 135 pilot training, and the adequacy of management oversight of pilot training for Part 135 commuter operators. KW - Air transportation crashes KW - Airline pilots KW - Commuter airlines KW - Flight training KW - Loss of control KW - Loss of control accidents KW - Pilot training UR - https://trid.trb.org/view/374343 ER - TY - RPRT AN - 00633398 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: MAYFLOWER CONTRACT SERVICES, INC., TOUR BUS PLUNGE FROM TRAMWAY ROAD AND OVERTURN CRASH NEAR PALM SPRINGS, CALIFORNIA, JULY 31, 1991 PY - 1993/04/13 SP - 67 p. AB - On July 31, 1991, a 1989 72-passenger school bus operated by Mayflower Contract Services, Inc., was traveling eastbound on undivided, two-lane Tramway Road from the Palm Springs, (California) Aerial Tramway parking lot. During the descent, the bus increased speed, left the road, plunged down an embankment, and collided with several large boulders. The bus driver and 6 passengers were killed; 47 passengers were injured. The safety issues discussed in this report are the adequacy of bus driver training in mountain driving techniques and proper transmission operation in mountainous terrain, motor carrier inspection and maintenance programs, State regulations on school bus inspection and maintenance procedures, school bus occupant protection, and traffic control devices on Tramway Road and traffic control standards applicable to private roads. As a result of its investigation the Safety Board issued safety recommendations to the Federal Highway Administration, the State of California, the California Department of Education, the California Highway Patrol, the Mount San Jacinto Winter Park Authority, the National Committee on Uniform Traffic Laws and Ordinances, the American Association of State Highway and Transportation Officials, the National Association of State Directors of Pupil Transportation Services, the General Motors Corporation Allison Transmission Division, and Mayflower Contract Services, Inc. KW - Bus crashes KW - Bus drivers KW - Crash investigation KW - Driver training KW - Fatalities KW - Highway safety KW - Injuries KW - Inspection KW - Motor carriers KW - Mountain roads KW - Occupant protection KW - Occupant protection devices KW - Private roads KW - Recommendations KW - School buses KW - Traffic control devices UR - https://trid.trb.org/view/374342 ER - TY - RPRT AN - 00633400 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: ABORTED TAKEOFF SHORTLY AFTER LIFTOFF, TRANS WORLD AIRLINES FLIGHT 843, LOCKHEED L-1011, N11002, JOHN F. KENNEDY INTERNATIONAL AIRPORT, JAMAICA, NEW YORK, JULY 30, 1992 PY - 1993/03/31 SP - 116 p. AB - This report explains the aborted takeoff and destruction of a Trans World Airlines L-1011 airplane, which was scheduled passenger flight 843, shortly after liftoff from John F. Kennedy International Airport, Jamaica, New York, on July 30, 1992. The safety issues discussed in the report include training and procedures for flightcrews in abnormal situations during the takeoff and initial climb phases of flight, flightcrew control responsibilities for all takeoffs, trend monitoring in airline maintenance and quality assurance programs, the failure of the stall warning system during ground or flight operations, and the location of an airport blast fence. Safety recommendations concerning these issues were made to the Federal Aviation Administration and the Port Authority of New York and New Jersey. KW - Aerodynamic stability KW - Air transportation crashes KW - Airport blast fence KW - Failure KW - Flight crews KW - Flight training KW - Recommendations KW - Stall KW - Systems KW - Takeoff KW - Warning signals KW - Workload UR - https://trid.trb.org/view/374344 ER - TY - RPRT AN - 00629100 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: CONTROLLED COLLISION WITH TERRAIN, GP EXPRESS AIRLINES, INC., FLIGHT 861, A BEECHCRAFT C99, N118GP, ANNISTON, ALABAMA, JUNE 8, 1992 PY - 1993/03/02 SP - 78 p. AB - This report explains the controlled collision into terrain of GP Express flight 861, a Beechcraft C99, N118GP, in Anniston, Alabama, on June 8, 1992. The safety issues discussed in the report are, for aircraft operating under 14 CFR Part 135, the importance of adequate preparation and experience of newly hired captains, available approach charts for each pilot, and adherence to specific stabilized approach criteria. The importance of adequate cockpit resource management is also discussed. Recommendations concerning these issues were made to the Federal Aviation Administration. KW - Air pilots KW - Air transportation crashes KW - Airline pilots KW - Approach KW - Approach charts KW - Cockpit resource management KW - Commuter airlines KW - Flight crews KW - Human error KW - Human factors in crashes KW - Recommendations KW - Stability criteria KW - Stabilized approach criteria KW - Terrain collisions KW - Training UR - https://trid.trb.org/view/369393 ER - TY - RPRT AN - 00629101 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: TAKEOFF STALL IN ICING CONDITIONS, USAIR FLIGHT 405, FOKKER F-28, N485US, LAGUARDIA AIRPORT, FLUSHING, NEW YORK, MARCH 22, 1992 PY - 1993/02/17 SP - 129 p. AB - This report explains the crash of USAir flight 405, a Fokker 28-4000, after an attempted takeoff from runway 13 at LaGuardia Airport, Flushing, New York, on March 22, 1992. The safety issues in the report focus on the weather, USAir's deicing procedures, industry airframe deicing practices, air traffic control aspects of the flight, USAir's takeoff and preflight procedures, and flightcrew qualifications and training. The airplane's impact with the ground, postaccident survivability, and crash/fire/rescue activities are also discussed. Safety recommendations concerning these issues are addressed to the Federal Aviation Administration, the Port Authority of New York and New Jersey, the Department of Transportation, and the New York City Health and Hospitals Corporation. KW - Air traffic control KW - Air transportation crashes KW - Deicing KW - Drowning KW - Fires KW - Flight crews KW - Icing conditions KW - Postaccident survivability KW - Preflight procedures KW - Qualifications KW - Recommendations KW - Search and rescue operations KW - Stall KW - Takeoff KW - Training UR - https://trid.trb.org/view/369394 ER - TY - RPRT AN - 00628893 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: TOMY INTERNATIONAL, INC., D/B/A SCENIC AIR TOURS, FLIGHT 22, BEECH MODEL E18S, N342E, IN-FLIGHT COLLISION WITH TERRAIN, MOUNT HALEAKALA, MAUI, HAWAII, APRIL 22, 1992 PY - 1993/02/02 SP - 68 p. AB - This report explains Scenic Air Tours flight 22's collision with mountainous terrain on the Island of Maui, Hawaii, while the Beech E18S airplane was on an air tour flight from Hilo, Hawaii, to Honolulu, Hawaii, on April 22, 1992. The safety issues discussed in the report include visual flight in instrument meteorological conditions, navigational errors, pilot preemployment qualifications and background checks, and the overall safety of the air tour industry. Recommendations concerning these issues were addressed to the Federal Aviation Administration and to Tomy International, Inc., d/b/a Scenic Air Tours. KW - Air pilots KW - Air tour industry KW - Air transportation crashes KW - Airline pilots KW - Crash investigation KW - Errors KW - Maui (Hawaii) KW - Meteorological conditions KW - Mountains KW - Navigation KW - Navigational errors KW - Qualifications KW - Safety KW - Tour operators KW - Weather UR - https://trid.trb.org/view/369206 ER - TY - RPRT AN - 00839065 AU - National Transportation Safety Board TI - RECREATIONAL BOATING SAFETY SAFETY STUDY. PY - 1993 IS - NTSB/SS-93/01 AB - No abstract provided. KW - Boating KW - Boats KW - Crashes KW - Safety KW - United States UR - https://trid.trb.org/view/531950 ER - TY - RPRT AN - 00840927 AU - National Transportation Safety Board AU - Amtrak TI - RAILROAD ACCIDENT REPORT: DERAILMENT AND SUBSEQUENT COLLISION OF AMTRAK TRAIN 82 WITH RAIL CARS ON DUPONT SIDING OF CSX TRANSPORTATION INC. AT LUGOFF, SOUTH CAROLINA, ON JULY 31, 1991. PY - 1993 IS - PB93-916303 AB - No abstract provided. KW - Crashes KW - Inspection KW - Lugoff KW - Maintenance KW - Railroads UR - https://trid.trb.org/view/532626 ER - TY - RPRT AN - 00839406 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT/INCIDENT SUMMARY REPORT: DERAILMENT OF AMTRAK TRAIN 87, SILVER METEOR, IN PALATKA, FLORIDA, ON DECEMBER 17, 1991. PY - 1993 IS - PB93-916302 AB - No abstract provided. KW - Crashes KW - Drug use KW - Locomotive engineers KW - Palatka KW - Railroads KW - Silver meteor (Express train) UR - https://trid.trb.org/view/532080 ER - TY - RPRT AN - 00838810 AU - National Transportation Safety Board AU - BURLINGTON NORTHERN RAILROAD COMPANY. TI - RAILROAD ACCIDENT REPORT: HEAD-ON COLLISION BETWEEN BURLINGTON NORTHERN RAILROAD FREIGHT TRAINS 602 AND 603 NEAR LEDGER, MONTANA, ON AUGUST 30, 1991.. PY - 1993 IS - PB93-916301 AB - No abstract provided. KW - Crashes KW - Dispatching KW - Ledger KW - Railroad trains KW - Railroads UR - https://trid.trb.org/view/531862 ER - TY - RPRT AN - 00840926 AU - UNITED STATES. SUBCOMMITTEE ON AVIATION. FOR SALE BY THE U.S. G.P.O., SUPT. OF DOCS., CONGRESSIONAL SALES OFFICE AU - Federal Aviation Administration AU - National Transportation Safety Board TI - RELATIONSHIP BETWEEN THE FEDERAL AVIATION ADMINISTRATION AND THE NATIONAL TRANSPORTATION SAFETY BOARD: HEARING BEFORE THE SUBCOMMITTEE ON AVIATION OF THE COMMITTEE ON COMMERCE, SCIENCE, AND TRANSPORTATION, UNITED STATES SENATE, ONE HUNDRED THIRD CONGRESS, FIRST SESSION, MAY 27, 1993.. SN - 0160416221 PY - 1993 AB - No abstract provided. KW - Aeronautics KW - Air transportation crashes KW - United States UR - https://trid.trb.org/view/532625 ER - TY - RPRT AN - 00840524 AU - National Transportation Safety Board TI - PIPELINE ACCIDENT REPORT: HIGHLY VOLATILE LIQUIDS RELEASE FROM UNDERGROYND STORAGE CAVERN AND EXPLOSION, MAPCO NATURAL GAS LIQUIDS, INC., BRENHAM, TEXAS, APRIL 7, 1992. PY - 1993 IS - PB93-916502 AB - No abstract provided. KW - Crashes KW - Natural gas pipelines KW - Pipelines KW - Texas UR - https://trid.trb.org/view/532502 ER - TY - RPRT AN - 00839482 AU - National Transportation Safety Board TI - MARINE ACCIDENT REPORT GROUNDING OF THE UNITED KINGDOM PASSENGER VESSEL RMS QUEEN ELIZABETH 2 NEAR CUTTYHUNK ISLAND, MASSACHUSETTS, AUGUST 7, 1992. PY - 1993 IS - PB93-916401 AB - No abstract provided. KW - Cuttyhunk island KW - Marine safety KW - Ship pilotage KW - Ship pilots KW - Water transportation crashes UR - https://trid.trb.org/view/532113 ER - TY - RPRT AN - 00839731 AU - National Transportation Safety Board TI - SPECIAL INVESTIGATION REPORT ACCIDENTS INVOLVING FOREIGN PASSENGER SHIPS OPERATING FROM U.S. PORTS, 1990-1991. PY - 1993 IS - PB93-917002 AB - No abstract provided. KW - Cruise ships KW - Marine safety KW - United States KW - Water transportation crashes UR - https://trid.trb.org/view/532163 ER - TY - RPRT AN - 00840966 AU - National Transportation Safety Board TI - RAILROAD ACCIDENT REPORT: COLLISION BETWEEN NORTHERN INDIANA COMMUTER TRANSPORTATION DISTRICT EASTBOUND TRAIN 7 AND WESTBOUND TRAIN 12 NEAR GARY, INDIANA, ON JANUARY 18, 1993. PY - 1993 IS - PB93-916304 AB - No abstract provided. KW - Commuter service KW - Commuting KW - Crashes KW - Gary (Indiana) KW - Railroad commuter service KW - Railroads UR - https://trid.trb.org/view/532632 ER - TY - RPRT AN - 00633233 AU - National Transportation Safety Board TI - ANNUAL REVIEW OF AIRCRAFT ACCIDENT DATA: U.S. GENERAL AVIATION, CALENDAR YEAR 1989 PY - 1993 SP - 86 p. AB - This report presents a statistical compilation and review of general aviation accidents which occurred in 1989 in the United States, its territories and possessions, and in international waters. The accidents reported are all those involving U.S. registered aircraft not conducting operations under 14 CFR 121, 14 CFR 125, 14 CFR 127, or 14 CFR 135. This report is divided into five sections: All Accidents; Fatal Accidents; Serious Injury Accidents; Property Damage Accidents; and Midair Collision Accidents. Several tables present accident parameters for 1989 accidents only, and each section includes tabulations which present comparative statistics for 1989 and for the five-year period 1984-1988. KW - Air transportation crashes KW - Crash victims KW - Fatalities KW - General aviation KW - Injury severity KW - Loss and damage KW - Midair crashes KW - Property KW - Property damage KW - Serious injury accidents KW - Statistics KW - United States UR - https://trid.trb.org/view/374233 ER - TY - RPRT AN - 00628892 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: UNITED AIRLINES FLIGHT 585, BOEING 737-291, N999UA, UNCONTROLLED COLLISION WITH TERRAIN FOR UNDETERMINED REASONS, 4 MILES SOUTH OF COLORADO SPRINGS MUNICIPAL AIRPORT, COLORADO SPRINGS, COLORADO, MARCH 3, 1991 PY - 1992/12/08 SP - 168 p. AB - This report documents the inexplicable loss of United Airlines flight 585, a Boeing 747-291, after the airplane had completed its turn onto the final approach course to runway 35 at Colorado Springs Municipal Airport, Colorado Springs, Colorado, on March 3, 1991. The safety issues discussed in the report are the potential meteorological hazards to airplanes in the area of Colorado Springs, potential airplane or systems anomalies that could have precipitated a loss of control, and the design of the main rudder power control unit servo valve that could present significant flight control difficulties under certain circumstances. Recommendations concerning these issues were addressed to the Federal Aviation Administration. KW - Air transportation crashes KW - Colorado Springs (Colorado) KW - Crash investigation KW - Hazards KW - Loss of control KW - Meteorological hazards KW - Rudder control systems KW - Rudders KW - Servo valves KW - Servomechanisms KW - Systems anomalies KW - Valves KW - Weather UR - https://trid.trb.org/view/369205 ER - TY - RPRT AN - 00628891 AU - National Transportation Safety Board TI - AIRCRAFT ACCIDENT REPORT: AIR TRANSPORT INTERNATIONAL, INC., FLIGHT 805, DOUGLAS DC-8-63, N794AL, LOSS OF CONTROL AND CRASH, SWANTON, OHIO, FEBRUARY 15, 1992 PY - 1992/11/19 SP - 121 p. AB - This report explains the loss of control and crash of Air Transport International, Inc., flight 805, a Douglas DC-8-63, near Toledo Express Airport, Ohio, after executing a second missed approach to runway 7, on February 15, 1992. The safety issues discussed in the report include unusual attitude recovery training for flight crews, crew fatigue, and cockpit resource management. KW - Air transportation crashes KW - Cockpit resource management KW - Crash investigation KW - Fatigue (Physiological condition) KW - Flight crews KW - Training UR - https://trid.trb.org/view/369204 ER - TY - RPRT AN - 00628894 AU - National Transportation Safety Board TI - SAFETY STUDY: ALCOHOL AND OTHER DRUG INVOLVEMENT IN FATAL GENERAL AVIATION ACCIDENTS, 1983 THROUGH 1988 PY - 1992/10/14 SP - 170 p. AB - This study examines alcohol involvement in fatal general aviation accidents that occurred from 1983 through 1988. Despite a downward trend in alcohol-involved general aviation accidents that were fatal to the pilot during the 1983 through 1988 period, about 6% of the fatally injured pilots in the study were flying while impaired. The mean blood alcohol concentration (BAC) of the alcohol-positive pilots was 0.15%, nearly four times the 0.04% BAC offense level established by current Federal Aviation Administration regulations. The safety issues discussed in this report are the need for comprehensive State laws pertaining to alcohol and drug use in general aviation, and the need to prevent pilots from flying while impaired by alcohol or other drugs. Recommendations concerning these issues were made to the Federal Aviation Administration, the States, the Aircraft Owners and Pilots Association, the Experimental Aircraft Association, the National Agricultural Aviation Association, the National Air Transportation Association, the National Association of Flight Instructors, and the National Association of State Aviation Officials. KW - Air pilots KW - Air transportation crashes KW - Airline pilots KW - Alcohol use KW - Blood alcohol levels KW - Drugs KW - Fatalities KW - General aviation KW - Prevention KW - State laws UR - https://trid.trb.org/view/369207 ER - TY - RPRT AN - 00626985 AU - National Transportation Safety Board TI - HIGHWAY ACCIDENT REPORT: MULTIPLE-VEHICLE COLLISIONS AND FIRE DURING LIMITED VISIBILITY (FOG) ON INTERSTATE 75 NEAR CALHOUN, TENNESSEE, DECEMBER 11, 1990 PY - 1992/09/28 SP - 93 p. AB - About 9:10 a.m. on December 11, 1990, during fog on Interstate 75 near Calhoun, Tennessee, 99 vehicles were in multiple-vehicle chain-reaction collisions that killed 12 people and injured 42 others. The safety issues discussed in this report are nonuniform driver behavior during limited-visibility conditions, detection of limited-visibility conditions, limited-visibility countermeasures, and hazardous materials container performance. As a result of its investigation, the Safety Board made recommendations addressing these issues to the United States Department of Transportation; the Federal Highway Administration; the National Highway Traffic Safety Administration; the Tennessee Department of Transportation; the Tennessee Highway Patrol; the American Association of Motor Vehicle Administrators; the Research and Special Programs Administration; Hercules, Incorporated; the Charleston Volunteer Fire Department; the American Automobile Association; and the American Driver and Traffic Safety Education Association. KW - Behavior KW - Chain-reaction collisions KW - Containers KW - Countermeasures KW - Detection and identification KW - Detectors KW - Drivers KW - Fatalities KW - Fog KW - Hazardous materials KW - Injuries KW - Interstate Highway System KW - Multiple vehicle crashes KW - Performance KW - Reduced visibility KW - Tennessee UR - https://trid.trb.org/view/368506 ER -