By Nicholas Worrell

Flight deck of the USS George Washington (CVN-73)I recently had an opportunity, with a team from Drivesmart Virginia, to speak about the importance of safe driving to 3,500 service members onboard the USS George Washington during their safety standdown. These members of the military go into harm’s way, where people are trying to kill them in direct combat operations. However, one enemy they often overlook when they return home is the danger of unsafe driving. Three of this enemy’s weapons on the road are distraction, fatigue, and impairment. Highway crashes kill over 35,000 Americans every year, and many of these crashes are preventable because they are a result of deadly weapons that we can control and defeat.

Nicholas Worrell speaks to sailors on board the USS George WashingtonMy interaction with the troops brought back fond memories of my time in the Marines. Having internalized the core values common to military service—honor, courage, and commitment—I felt the need to pursue a career where I could continue to make a difference after leaving the Marines. Joining the NTSB allowed me to do just that. Even before speaking to the crowd aboard the USS George Washington, I knew that the core values I learned as a Marine had guided me in my safety career, but it wasn’t until I was in front of 3,500 sailors that I was able to put that into words.

Service men and women live and breathe the core values of honor, courage, and commitment every day through discipline and accountability. These core values are also applicable to daily safe driving habits they can apply when they get off the ship and back on the road. Here’s what I said about these core values:

Honor. There is honor in saving American lives, including your own and other drivers on the roads. There is also honor in saving American lives by working to make our roadways safer and educating others about the hazards of impaired driving.

Courage. There is courage in standing up for your beliefs and speaking out about what is right, especially as it relates to road safety. It can be hard to tell someone to put their phone down or to take a taxi, but you have the courage to do just that and save a life.

Commitment. It takes commitment to make the right choice and stick to it every time.

Wearing a seat belt or a helmet is a choice you make. So is choosing to drive unimpaired by alcohol, drugs, distraction, or fatigue. A commitment to reducing motor vehicle crashes starts with your own individual behavior and continues as you educate others on the dangers of impaired and distracted driving.

I called on each of these sailors to apply these values to their daily lives when they return to shore. I spoke to them about the importance of planning ahead, getting enough rest, and avoiding distracted driving, and I urged them to apply those values—honor, courage, commitment—to make safe driving a priority in their lives.

According to Sun Tzu, the author of The Art of War, “Every battle is won or lost before it is ever fought.” The same is true for safe driving—often the war is won or lost before a driver gets behind the wheel. I encourage all individuals to adopt the values of our service members by having the honor to do what is right when they’re considering driving, having the courage to take an impaired friend’s keys or call a cab when they’ve had too much to drink or not enough rest, and having the commitment to making a plan before they get behind the wheel.

Nicholas Worrell, USMC (Ret.), is Chief of the NTSB Safety Advocacy Division

Reflecting back on 10 years as a Board Member

By Robert Sumwalt

On August 21, 2006, I was sworn in as the 37th member of the National Transportation Safety Board. At the same time, I was appointed by President George W. Bush to serve as NTSB Vice Chairman. In 2011, President Barack Obama reappointed me for an additional five-year term as a board member.

Robert Sumwalt, taking the oath of office, administered by then-NTSB Chairman Mark V. Rosenker on August 21, 2006.
Robert Sumwalt, taking the oath of office, administered by then-NTSB Chairman Mark V. Rosenker on August 21, 2006.

As I reflect on 10 years as an NTSB board member, there are several things that stand out. First, is the mission. Our role in transportation safety quickly became apparent when, on my seventh day on the job, I launched to an airline crash in Lexington, Kentucky. Tragically, that crash claimed 49 lives.

But, the NTSB’s primary mission involves more than just investigating accidents. It also involves determining the cause of accidents, and then, most importantly, issuing safety recommendations to prevent future accidents. At the entrance to our training center, we have an etched glass window that says, “From tragedy we draw knowledge to protect the safety of us all.” And that’s exactly what we do – we learn from tragedy so we can keep it from happening again.

Recently, one of our investigators wrote to me about a rail accident he investigated where fire and explosion claimed multiple lives. He told of meeting a man who was glaring at the carnage as he pushed a baby in a carriage. As it turned out, the man’s wife – the baby’s mother – had been killed in the disaster. Our investigator promised the man that the NTSB would get to the bottom of why this event occurred so other accidents could be prevented. “I also watched a man standing outside of the exclusion zone peering over the barrier in tears as a backhoe demolished his home,” the investigator explained in his note to me. “My thoughts were of those victims, and it was clear that we were being called upon to do this for them.”

Yes, we are here to give a voice to those who don’t have a voice—the victims and their families of transportation accidents. I take great solace knowing our work really does make a difference and keeps others from enduring similar tragedies.

The NTSB is an independent federal agency – meaning, we are not attached to a larger federal organization such as the U.S. Department of Transportation. In my opinion, independence is one of our greatest virtues because it allows the agency to conduct investigations and explore safety issues without being encumbered by actual or perceived political pressures. As I’ve often said, our independence allows us to “call it the way we see it.”

What also stands out to me is the dedication of the men and women of the NTSB. Their passion and determination to find the truth is uplifting. In the most recent employee viewpoint survey, 96 percent of respondents replied positively to the statement, “When needed I am willing to put in the extra effort to get a job done.” That demonstrates the commitment and dedication NTSB employees share for fulfilling our mission.

In addition to investigative activities, there is a proactive side to the NTSB. Our staff conducts safety studies, tracks and follows up on our safety recommendations, and advocates for safety improvements by providing testimony on safety issues, promoting our Most Wanted List, bringing important safety issues into the public discussion via social media efforts, and organizing safety events such as roundtable discussions.

One of the NTSB’s values is transparency; we are open and honest with the public about our work. We post on our website all accident reports and publications, as well as the docket for each accident. The docket provides reams of background information for accidents, such as interviews, photos, and technical information that may not be in the actual accident report. Our board meetings are webcast and open to the public. And, our Office of Safety Recommendations and Communications ensures the media are informed of the status of investigations by answering questions, arranging interviews, issuing press releases, and releasing updates through social media.

Many are surprised to learn that the NTSB also serves as a court of appeals for pilots, aircraft mechanics, and mariners who receive violation notices from the Federal Aviation Administration and U.S Coast Guard. The NTSB’s Office of Administrative Law Judges (ALJ) processes those cases, and our three ALJs hold hearings to adjudicate those matters.

The NTSB’s Office of Transportation Disaster Assistance – a highly trained group with expertise in social services, emergency management, and forensics – works closely with various organizations to meet the needs of disaster victims and their families. This group also serves as the primary point of contact for family members and disaster victims, providing updates regarding the status of NTSB investigations and addressing their questions. It takes a special person to do the work they do, and I’m always appreciative of how well they do it.

There are other parts of the agency that aren’t often acknowledged, but nevertheless are important to allowing the agency to function. As in any organization, job openings need to be posted and filled, bills paid, contracts written and executed, and our computers maintained. The employees who perform these functions are as dedicated as those performing the agency’s core mission.

To put it simply, I’m so proud to be part of this agency. Our mission, independence, transparency, and people are all so important. I’m honored to have served with them for the past 10 years.

Robert Sumwalt is an NTSB board member.

How Will You Send Your Kids to School? – Make Safety Your First Priority

By Leah Walton

I’ve worked in the traffic safety arena for more than 10 years. I know the rules of the road, I know the traffic statistics, and I know the safest mode of transportation.   

But what I don’t know yet is how I will feel when I send my first child to kindergarten. The first day of school is fast approaching, and I admit I’m getting emotional about it. Will my son be safe and happy in this new environment? Will he make friends? Is he ready for kindergarten? Where did the time go?

One thing we should also ask ourselves: how will our children get to and from school and what is the best way of getting there?

The best way to get to and from school varies from family to family, and sometimes even student to student. We must take into consideration all the options and determine the safest way to transport our children.

Students can travel by school bus, family vehicle, public transportation, bicycle, or walking. Regardless of the way they get there and back, we must teach them – and demonstrate for them – the safest practices and behaviors.

Will your child ride the school bus? It should be your first choice if it is an option for your family.  Statistically, the school bus is the safest form of transportation on America’s roadways. Before your child steps on the school bus, talk to them about how to ride the bus safely. Remind them to wait at the bus stop until the bus comes to a complete stop and the driver signals that it’s ok for them to get on. Once on the bus, they should sit quietly in their seat facing forward, buckle their seat belts if the school bus has them, and hold the handrail when getting on or off the bus.

Will your child walk or bike to school? That’s an excellent way to reach the U.S. Department of Health and Human Services’ recommended 60 minutes or more of daily physical activity! It is recommended that children under the age of 10 walk with an adult or an older, responsible sibling. Talk to your children about walking safely, using crosswalks and sidewalks, and walk the route with them before school starts to practice being a safe pedestrian. If they ride their bike, make sure they wear their helmet – a helmet is the best protection against head and brain injury. Review bicycle safety tips and practice the ride with them too, to ensure they are safe and ready.

Will your child ride with you or drive themselves to school? It is important to note that more students are killed while riding or driving in a passenger vehicle than any other mode of transportation. If this is your family’s only or best option, make sure everyone is as safe as possible in the family vehicle. Make sure everyone is in the right type of seat for their size, has their seat belt fastened, and is free of distractions (if driving)

source: National Highway Traffic Safety Administration

Back to school safety isn’t just an important consideration for parents and caregivers of schoolchildren – back to school safety should be a priority for all community members. Today, the NTSB hosted a press event that featured the “Look Out for Each Other” campaign of Montgomery County, Maryland, which reinforces the sentiment that traffic safety involves everyone. We must all work together to make sure everyone reaches their destination safely – whether we are on our way to work, out for an evening with friends, or headed off to the first day of school.

Back to school time comes with many mixed emotions – especially for me now. But, with proper planning, fears around how our children will get to and from school should not be among them.

Leah Walton is a Safety Advocate for NTSB

Roundtable Review – Part 2: The latest on rail tank car safety

By Robert L. Sumwalt

In last week’s blog, Roundtable Review-Part 1, I provided an overview of the NTSB’s July 13, 2016, rail tank car roundtable. Today’s blog discusses how the industry is monitoring its progress and the available options for meeting the earliest federal deadlines.

FAST Act Phase-out ScheduleFollowing the February 2015 crude oil derailment and fire near Mt. Carbon, WV, the NTSB issued an urgent recommendation calling for the Department of Transportation to make a “publicly available reporting mechanism that reports at least annually, progress on retrofitting and replacing tank cars.” Section 7308 of the FAST (Fixing America’s Surface Transportation) Act calls for the DOT Secretary to implement a reporting mechanism to monitor industry-wide progress toward meeting these federally-imposed deadlines. Many who participated in the roundtable were optimistic that the deadlines could be met.

More than two dozen rail tank car owners, operators, and manufacturers, as well as labor union representatives and transportation safety associations, came together to discuss ways industry and government can work together to overcome the challenges associated with meeting federally-imposed mandates that involve phasing out both legacy DOT-111 and CPC-1232 tank cars that carry flammable liquids (see image of timetable).

Participants addressed concerns with issues surrounding replacing older specification tank cars. “The one thing is to make sure we’ve got the best inspection and prevention techniques and technologies that we can possibly deploy,” said Hal Gard.

Gard is the rail administrator with Oregon’s DOT, a state which saw 42,000 gallons of crude oil spill along a scenic stretch along its revered Columbia River in Mosier after a derailment of CPC-1232 tank cars in June. “It was a bad day,” Gard said. “The CPC-1232s actually performed well, [but] we still are going to have to deal with the aftermath of that accident for a while.”

During the meeting, the roundtable participants dug into various details of and challenges associated with implementing the provisions of the FAST Act—for example, addressing differences between the types of tank cars currently in crude oil and ethanol service, specifications of the new DOT-117 cars, and various options available to the industry to retrofit.

Most agreed that it would take a sustained, concerted effort from all industry parties working together to meet the required deadlines. The shipper is responsible for the proper packaging of whatever they’re going to ship, reminded Robert Hulick, executive vice president with Trinity Rail. He said that many play a role in meeting deadlines, including the tank car owners and those who lease the cars. “It’s not any one party that makes that decision unilaterally,” he said.

Denford Jaja, with the Hess Corporation, agreed that there needs to be “a joint effort between the industry, the shippers, railroads, [and] the regulatory bodies.”

Jaja also said that when all parties involved have access to clear, validated information, it is easier to measure progress toward the goal. “We are fully supportive of a science- and fact-based approach to safety,” he said. “The faster we can resolve uncertainties, I think that’ll give us some certainty on the path forward.”

Andreas Aeppli, principal with Cambridge Systematics, said everyone who has a vested interest or role in the transport of commodities by rail needs to continue to educate themselves and understand what is actually required. For instance, while some of the most distant federal deadlines for halting the transport of crude oil and ethanol in DOT-111 and CPC-1232 tank cars aren’t until May 2025, the earliest mandates for some tank cars take effect much sooner, on January 1, 2018.

“It’s really important to have…information available because it’s freely out there. When you want to hold people’s feet to the fire, particularly as we get closer to the deadlines, [we need] to ensure that everybody is aware of what’s going on and adheres to the regulations and requirements that are being called for,” Aeppli said.

As stated in last week’s blog, those participating in the roundtable left feeling hopeful that progress would continue to be made. William Bates, a labor union legislative director with SMART Transportation Division, was among those who are cautiously optimistic. Addressing the entire roundtable, he said: “I would have the peace of mind knowing that I got the best equipment there. I hope that every car I pull is a [DOT] -117 or [one that has been] retrofitted. We need everybody’s help. Let’s get on the ball!”

For a complete transcript of the roundtable, see our “Events” page.

Robert L. Sumwalt is an NTSB Board Member and he moderated the roundtable

Crash Investigations in All Modes Inform Our Perspective on ‘Driverless’ Cars

By Christopher Hart

For decades, the automotive industry has been using technological advances, such as seat belts, air bags, and structural crush resistance, to protect us if we’re in a crash.  Those advances have undoubtedly saved thousands of lives a year.  Now we have the exciting opportunity to use technological advances to prevent crashes from happening in the first place, which can save tens of thousands of lives a year. But because automation will coexist with human drivers for the foreseeable future, there will be many challenges.

Driverless cars could save many, if not most, of the 33,000 lives that are lost every year on our streets and highways – a very tragic and unacceptable number that has been decreasing for several years but has recently taken a turn in the wrong direction.

Most crashes on our roads are due to driver error. The theory of driverless cars is that if there is no driver, there will be no driver error. Ideally, removing the driver would address at least four issues on the NTSB’s Most Wanted List of Transportation Safety Improvements – fatigue, distractions, impairment, and fitness for duty. The automation in driverless cars would presumably also address a fifth item on our list, namely, improved collision avoidance technologies.

Decades of experience in a variety of contexts has demonstrated that automation can improve safety, reliability, productivity, and efficiency. That experience has also demonstrated that there can be a downside. As noted by Professor James Reason, who is a world-renowned expert in complex human-centric systems:

In their efforts to compensate for the unreliability of human performance, the designers of automated control systems have unwittingly created opportunities for new error types that can be even more serious than those they were seeking to avoid.

Our investigation experience provides three lessons learned that support Prof. Reason’s statement. The first is that the theory of removing human error by removing the human assumes that the automation is working as designed. So, the question becomes: what if the automation fails?

An example of the automation failing without the operator’s knowledge occurred in Washington, DC, with the Metro crash near the Fort Totten Station in 2009 that tragically killed the train operator and 8 passengers. In that accident, a train temporarily became electronically invisible, whereupon the symbol of the train disappeared from the display board in the dispatch center.

Unfortunately, when the train became electronically invisible, there was no alarm in the train behind it regarding the electronic disappearance of the preceding train. By the time the operator saw the stopped train and applied the emergency brake after coming around a curve – which limited her sight distance – it was too late.

Another lesson learned in support of Prof. Reason’s statement is that even if the operator is removed from the loop, humans are still involved in designing, manufacturing, and maintaining the vehicles, as well as the streets and highways they use. Each of these points of human engagement presents opportunities for human error. Moreover, human error in these steps is likely to be more systemic in its effect – possibly involving several vehicles – and more difficult to find and correct. An example of this lesson learned is the collision of an automated – driverless – people mover into a stopped people mover at Miami International Airport in 2008. That collision was caused largely by improper maintenance.

The most fundamental lesson learned from our accident investigation experience in support of Prof. Reason’s statement is that introducing automation into complex human-centric systems can be very challenging. Most of the systems we have investigated are becoming increasingly automated but are not fully automated. As a result, we have seen that the challenges can be even more difficult in a system that is not completely automated but still has substantial human operator involvement.

With that background on how automation can be both the good news and the bad news, how can the NTSB help inform the process of moving toward driverless cars?

First, we offer considerable experience regarding the introduction of automation into complex human-centric systems.

Most of our investigations involve relatively structured systems with professional operators who are trained extensively (including, typically, on the automation) and have various requirements regarding proficiency, fatigue, impairment, distraction, and fitness for duty. Given that human drivers will probably be in the loop for some time to come, I would suggest that as difficult as the transition to more automation has been in the structured and regulated environments we have investigated, it may be even more challenging in a public arena, in which drivers are usually not highly trained and may be fatigued, impaired, distracted, or not medically fit.

The second way that the NTSB can help relates to collaboration. The auto industry has already recognized the importance of collaboration, as most recently shown by their collaborative approach regarding the voluntary installation of autonomous emergency braking by 2022. Our experience with collaboration, especially regarding commercial aviation, may help improve it further.

Although automation has played an important role in the commercial aviation industry’s continuing safety improvement, much of the industry’s exemplary safety record is attributable to collaboration. In the early 1990s, after the industry’s accident rate had been declining rapidly, the accident rate began to flatten on a plateau. Meanwhile, the Federal Aviation Administration was predicting that the volume of flying would double in 15-20 years.

The industry became very concerned that if the volume doubled while the accident rate remained the same, the public would see twice as airplane crashes on the news. That caused the industry to do something that, to my knowledge, has never been done at an industry-wide level in any other industry – they pursued a voluntary collaborative industry-wide approach to improving safety.

The voluntary collaborative process, known as CAST, the Commercial Aviation Safety Team, brings all of the players –airlines, manufacturers, pilots, air traffic controllers, and the regulator – to the table to do four things: Identify the potential safety issues, prioritize those issues – because they would be identifying more issues than they had resources to address, develop interventions for the prioritized issues, and evaluate whether the interventions are working.

This CAST process has been an amazing success. It resulted in a reduction of the aviation fatality rate, from the plateau on which it was stuck, by more than 80% in less than 10 years. As an observer in CAST, the NTSB can help the auto industry determine how much of this aviation industry success story is transferrable to them.

The third way that the NTSB can inform the process of introducing automation relates to on-board event recorders. Our investigations are significantly enhanced when we have event recorders to tell us what happened. Airliners have had “black boxes” – which are actually orange — for decades, to record both the aircraft parameters and the sounds in the cockpit. Other transportation modes are increasingly introducing event recorders as well as audio and video recorders.

There have already been crashes as a new wave of automation has been introduced which handles some or all of the driving task. The more that the industry knows from event recorders about what went right and what went wrong, the more the industry will be able to fashion remedies that effectively address the problems. Accordingly, consistent with another item on our Most Wanted List – Expand the Use of Recorders to Enhance Transportation Safety – we would encourage the use of robust on-board event recorders to help the process.

The NTSB will continue to investigate highway crashes when the investigation can illuminate important safety issues, including issues arising from automation. In addition, we are willing and able to work with the automotive industry before accidents happen.

The NTSB has already engaged with the industry and regulatory agencies to help inform how driverless cars can be safely introduced into America’s transportation system. Our experience in the introduction of automation into human-centric systems, our appreciation of the power of collaboration, and our understanding of the importance of on-board event recorders all position the NTSB to provide valuable assistance to the process.

(Excerpted in large part from a presentation that I gave at the National Press Club on June 30, 2016. Go here for the full speech)