ISASI Web RoundUp News 1

Issue No. 11—September-October, 2015, Editor: J. Gary DiNunno

ICAO Proposes to Upgrade Flight Data and Voice Recorder Requirements

“Air Safety Through Investigation”

The ISASI-ICAO Working Group reviewed ICAO State Letter SP55/4-15/15, dated 15 May 2015, that con-

tained proposed amendments to Annex 6 regarding upgrading flight data and voice recorder requirements,

including the subject of deployable recorders. The Working Group developed a reply to ICAO for ISASI

President Frank Del Gandio’s signature.

ISASI’s response notes that the Society “agrees in principle” with the proposed amendments to Annex 6,

parts I, II, and III and offers no comments. However, ISASI disagrees and offers comments regarding pro-

posed amendments outlined in attachment B, amendment to Annex 6 concerning combination recorders in

international air transport aircraft.

ISASI observed that the Global Aeronautical Distress and Safety System (GADSS) was fully discussed

during this year’s High level Safety Conference and that proposed amendments “may be premature in light

of emerging datalink technology.” Such emerging technology “may overcome possible needs to provide up-

graded flight recorder capabilities,” ISASI suggested. “With the rapid development of communications and

navigation capabilities,” the Society said, “upgraded flight recorder standards may be performance based,

rather than tied to a specific ADFR requirement” as ICAO proposes. ISASI suggested a need for the ICAO

Air Navigation Bureau to “continue study involving industry and regulators to evaluate and monitor the tech-

nical developments of GADSS and the need for a prescriptive mandate for automatic deployment flight re-

corders.”

Note Date Change: ISASI 2016 in Reykjavik,

Iceland, October 17-20, 2016.

The work of the members of the ICAO Accident

Investigation Panel (AIGP) has continued by

means of email and conference calls by the eleven

Working Groups formed in April 2015 at the AIGP

meeting in Montreal. Ron Schleede, Bob MacIn-

tosh, and Nick Stoss are participating in 4 of the

Working Groups. Each Working Group will pro-

vide a status report to the AIG Secretary quarterly

before the next formal AIGP meeting to be held in

April or May 2016. For more information, go to

http://www.isasi.org/Documents/EventsAndAlerts/

Trip_Report_AIGP June 30, 2015.pdf. ♦

ISASI Works with AIGP

ISASI Web RoundUp News 2

ISASI member Steve Sparks reports that members

of the ISASI General Aviation (GA) Working

Group met at this year’s Annual Seminar in Germa-

ny to discuss initiatives for the upcoming year.

He said there were approximately 25 participants

representing academia, government, industry and

manufactures who took advantage of this oppor-

tunity to discuss issues influencing GA accident

investigations.

Some of the topics discussed included: Fatal GA

accident statistics and trends, Human Factors, train-

ing, flight data monitoring systems, investigation

vs. prevention and best practices utilized by acci-

dent investigators.

The group also discussed the importance of teach-

ing pilots about Risk Management and Aeronauti-

cal Decision Making (ADM) for minimizing over-

all risk to themselves and their passengers.

The GA Working Group decided to press forward

in designing a simple to use checklist to aid investi-

gators in gathering Human Factors data related to

an accident investigation.

Unfortunately, 80 to 90 percent of all accidents are

still influenced by human error and so the Working

Group wanted to focus on a project that helps to-

wards reducing this negative effect. The intension

of this new checklist tool is to help uncover Human

Factor issues that led or contributed to an accident

so that mitigation strategies can be developed to

prevent further accidents or incidents.

Society President Frank Del Gandio notes that

Steve Sparks and Doug Cavannaugh will be ap-

pointed co-chairmen of this Working Group.

“ISASI is grateful,” Del Gandio said, “for all the

work of previous chairman, Jim Viola to get the

Society’s ISASI GA Working Group well estab-

lished and running smoothly.” There is a robust

distribution list being formulated to assist the Gen-

eral Aviation Working Group on projects and infor-

mation sharing regarding GA accident investiga-

tions. If Society members would like to become a

member of the GA Working Group, please contact

Steve Sparks (steven.sparks@faa.gov) or Doug

Cavannagh (douglas.cavannagh@outlook.com). ♦

ISASI General Aviation Working Group News

CHC Safety and Quality Summit The call is out for papers that will characterize the 2016 edition of the world’s largest helicopter-safety con-

ference, the CHC Safety & Quality Summit. The CHC Safety & Quality Summit is hosted by ISASI corpo-

rate member, CHC Helicopter, the operating company of CHC Group Ltd.

Industry and safety professionals interested in presenting at the CHC Safety & Quality Summit may now

submit abstracts for the event. The 12th-annual summit will be held April 04-06, 2016 at the Westin

Bayshore Resort in Vancouver. Last year’s event drew more than 750 delegates from about 25 countries.

The 2016 summit will explore topics relevant to the theme “Back to Basics: Prioritizing Safety in a Chal-

lenging Economy.”

Most sessions during the three-day conference will be for 90 minutes, though some subjects may span

one-half of or an entire day. Attendance at individual sessions typically numbers 50 or more people.

The submission form for papers is available at www.chcsafetyqualitysummit.com ,

Submissions should include proposed session titles, descriptions or outlines, objectives and audience bene-

fits, presenter biographies, and contact details. Relevant topics may include: Integrity and Management;

Technology and Safety Methods of Training; Crisis Management; Organizational Leadership and Viability;

Fatigue Risk Management; Human Factors; Risk Assessment and Hazard Management; Human Error Man-

agement; Flight Data Monitoring; HUMS; Organizational Causes of Accidents; Sustaining and Improving

Industry Safety; Management System for Reducing Safety Risk and Business Risk; Safety Management

Tools; Crew Resource Management; and Practical Tools. Please send all submissions to summit@chc.ca

CHC Helicopter’s customers include oil and gas companies, government search-and-rescue agencies and

organizations requiring helicopter maintenance, repair and overhaul services through the Heli-One seg-

ment. The company has a fleet of more than 230 aircraft and operates in approximately 20 countries around

the world. ♦

ISASI Web RoundUp News 3

The October-December issue of

ISASI Forum is being finalized

and is scheduled for mailing in

mid-October. The magazine will

feature articles about the 2015

ISASI seminar that was held in

Augsburg, Germany and will in-

clude several of the outstanding

papers presented during plenary

sessions.

About the cover: ISASI Presi-

dent Frank Del Gandio, right, pre-

sents the prestigious ISASI Je-

rome F. Lederer Award to Lad-

islav (Ladi) Mika, the 2015 recip-

ient (see page 11), before a ban-

quet audience of 280 ISASI dele-

gates and guests.

Page 3, “President’s View”—

Aviation’s Global Impact on Im-

proving Air Safety.

Page 5, Augsburg, Germany:

ISASI 2015, ‘Independence Does

Not Mean Isolation,’ by Es-

perison Martinez, Editor. Hosted

by the ISASI European Society of

Air Safety Investigators, the an-

nual ISASI conference drew 344

delegates and guests from 43

countries.

Page 11, Ladislav Mika Is

ISASI’s 2015 Lederer Award Re-

cipient , by Esperison Martinez,

Editor. The 2015 presentation

marks the 39th year that ISASI

has presented the award.

Page 14, Divorcing the Regula-

tor: The Establishment of an In-

dependent Investigative Authority

by Capt. Ibrahim S. Koshy, Di-

rector General, Aviation Investi-

gation Bureau, Kingdom of Saudi

Arabia. This paper received the

Best of Conference Award of Ex-

cellence for technical papers pre-

Next ISASI Forum Highlights 2015 Seminar

monitoring systems (HUMS) by

identifying new and newly applied

sensing technologies, with a spe-

cific focus on internal sensors for

rotating systems of helicopters.

Page 26, Change Point Analyses

Applied to SMS, by Paulo Manoel

Razaboni, Embraer Air Safety De-

partment. The author seeks to bet-

ter understand the behavior of

safety-related items, using a statis-

tical approach to support strategic

decisions.

Page 32, “Who’s Who” Flight

Data Systems: A Multi-Avionics

Product and Service Provider. ♦

sented during ISASI 2015.

Page 16, ISASI Scholarship

Recipients Receive Awards, by Es-

perison Martinez, Editor. ISASI

2015 awards banquet attendees

enthusiastically honored the four

recipients of ISASI's Kapustin Me-

morial Scholarships.

Page 19, Towards the Next Gen-

eration of HUMS Sensor, by Dr.

Matthew Greaves, Head, Safety

and Accident Investigation Centre,

Cranfield University. The author

describes a research program that

aims to inform the next generation

of helicopter health and usage

Above: Society President Frank Del Gandio, right, presents

Luis Garcia Air Defense & Space a corporate membership

plaque during ISASI 2015.

ISASI Web RoundUp News 4

Speakers and Papers Presented at ISASI 2015 Tuesday 25 August

09:00

ISASI President: Frank Del Gandio

Welcome address by Dr Kurt Gribl, Lord Mayor

of Augsburg

Keynote address: Ulf Kramer, Head of the BFU

and President of ENCASIA

09:00

Moderator Arnaud Desjardin, Dep. Manager,

BEA Investigation Department

A small accident but a very complex investiga-

tion: Leo P Murray, AAIU, Ireland

Investigating the Voyager pitch down incident:

Col. Crispin Orr, Head of UK Military AAIB

A new tool analysing the potential influence of

vestibular illusions: Eric Groen, TNO; Simon

Lie, Boeing

14:00

Moderator: Jurgen Whyte, Chief Inspector of

AAIU, Ireland

AirAsia QZ8501: A family tragedy: Tony Fer-

nandes, Group Chief Executive, AirAsia Group

Challenges of sea search and recovery opera-

tions: Tatang Kurniadi, Chairman, NT SC, In-

donesia and Ng Junsheng, Accident Investigator,

AAIB, Singapore

Independence does not mean Isolation - A

practical approach: Johann Reuss, BFU

Feedback from the tutorial on social dimension

of a safety investigation: Olivier Ferrante - Eu-

ropean Commission

Wednesday 26 August 09:00

Keynote address - Rémi Jouty, Director of the

BEA, France

Moderator: Frank Hilldrup, International Aviation

Adviser, NTSB, USA

Unstable approaches - a global problem: David

Ross, Senior Regional Operations Investigator,

TSB, Canada

How to address the BIG THREE?: Frederic

Combes, Airbus France

Investigating human factors - a tale of two ac-

cidents: Katherine Wilson, NTSB, USA

Fixing the holes: Infrastructure, Training,

Oversight: Alain Agnesetti and Arnaud

Desjardin, BEA France

14:00

Moderator: Nuno Aghdassi, Head of Flight Safe-

ty, NetJets

Can investigation of civil air accidents be truly

independent?: Andrew Cox, Rolls-Royce, UK

The threat to independence and impartiality

when using manufacturer’s resources and ex-

pertise: Bob Vickery, Senior Inspector, UK

AAIB

Use of modern technologies and methodolo-

gies to improve helicopter accident investiga-

tion: Thomas Gogel, Seth Buttner, Airbus

Helicopters and Marcus Bauer, Msimulation

Independence of accident investigation au-

thorities: Marcus Costa, ICAO

Thursday 27 August 09:00

Keynote address - Yannick Malinge, Vice Presi-

dent & Chief Product Safety Officer, Airbus

Moderator: Captain Ed Pooley, Air Safety Con-

sultancy

Boeing 787 lithium battery incidents: L ori

Anglin, Airplane Accident Investigator, Boeing

Commercial Airplanes and John R Lowell, Tech-

nical Fellow, Boeing Research & Technology

Divorcing the regulator - the establishment of

an independent investigative authority: Cap-

tain Ibrahim S Koshy, AIB, Kingdom of Saudi

Arabia

Human factors in extremis: the rogue pilot

phenomenon: Thomas Anthony, University of

Southern California Aviation Safety and Security

Program

EASA and the independence of safety investi-

gation: Bernard Bourdon, EASA

14:00

Moderator: Mike Gamlin, Manager - Air Safety

Investigation at Rolls-Royce

Lessons learned from transport Airplane acci-

dents: Daniel Cheney, FAA, USA

Is it a space plane or a rocket? The unique as-

pects of a commercial space accident investi-

gation: E. Lorenda Ward, NTSB, USA

Introduction to ISASI 2016: T horkell

Agustsson, ITSB, Iceland ♦

Find all papers presented at ISASI 2015 at http://www.isasi.org/Library/technical-papers.aspx

ISASI Web RoundUp News 5

Shown above: Alister Buckingham, NZSASI president, left, accepts a corporate membership

plaque on behalf of Massey University. Shown below: Glen Jones (center) chairman of the

Reachout Committee meets with his committee members at ISASI 2015.

AsiaSASI Elects EXCO Leadership The Asia Society of Air Safety Investigators (AsiaSASI) was

formed in March 2009. All ISASI members in Asia are automat-

ically AsiaSASI members and there is no separate membership

fee for the AsiaSASI.

The first AsiaSASI Executive Committee (EXCO) was elect-

ed on 4 September 2009. The AsiaSASI has undergone three

elections of Exco since then. The third Exco is coming to the

end of its term and an election for the fourth Exco was held re-

cently.The following members have been elected by the

AsiaSASI members to be the fourth EXCO: President: Hong

Kong Civil Aviation Department (HK CAD); Vice President:

Japan Transport Safety Board (JTSB); Secretary: Air Accident

Investigation Bureau of Singapore (AAIB Singapore). ♦

ISASI Web RoundUp News 6

ISASI Corporate member, Flight Safety Foundation

announced in August the launch of a new website in

support of its Global Safety Information Project

(GSIP) and shared preliminary findings from the fo-

cus groups it held earlier this summer. The new web-

site is <www.fsfgsip.org>.

So far, the Foundation has held 10 focus groups

across the two regions, including Wellington, New

Zealand; Sydney, Australia; Singapore; Hong Kong;

Kuala Lumpur, Malaysia; Tokyo, Japan; New Delhi,

India; Lima, Peru; Mexico City, Mexico; and Panama

City, Panama. Additional focus groups are scheduled

soon to be held in São Paulo, Brazil, and Kingston,

Jamaica.

"We've seen positive results with a diverse group of

passionate safety professionals in our focus groups.

Participants have come from every segment of the

aviation industry, yet common themes emerged at

every focus group. This means that our initial analy-

sis of the information gathered gives us balanced but

Flight Safety Foundation Launches GSIP Website With Preliminary Findings from Focus Groups

preliminary insight into safety data collection sys-

tems in Pan America and Asia Pacific," said project

lead Mark Millam, FSF vice president, technical.

The first public reporting of findings can be found

on the GSIP website at <www.fsfgsip.org/news/>.

The next phase of work is scheduled to start in the

first quarter of 2016 with a number of workshops in

the targeted regions. "We'll use the information we

have been collecting from all of our focus groups to

develop guidance materials. The workshops will be

an opportunity to obtain more expert assistance

from the stakeholders in Asia Pacific and Pan Amer-

ica in the completion of these guidance materials,"

Millam stated.

Future project activities will include the develop-

ment of these globally focused tool kits to be used by

states to develop and implement voluntary safety re-

porting programs that include protections against pu-

nitive action by regulatory agencies and/or employ-

ers, as allowed by the respective national law. ♦

New Individual Members

Anderson, Christina E.; Clifton, VA, USA

Andersson, Ulf; Linköping, Sweden

Antunes, Luis M.; Porto, Portugal

Apostolou, Andreas; Aglangia, Cyprus

Averna, Andrew, R.; Glen Head, NY, USA

Borsi, Vittorio; Rome, Italy

Engdhl, Stefan RT; Ronneby, Sweden

Farkas, Laszio; Vecses, Hungary

Friesacher, Thomas M.; Salzburg, Austria

Galatis, Andreas; Nicosia, Cyprus

Gentilli, Glauco; Montefiascone, Italy

Hajmburger, Vlatko; Zagreb, Croatia

Hepher, Tim; Paris, France

Kazuzuru, Salome N.; Dar Es Salaam, Tanzania

Kerkoff, Jan; Hoofddorp, Netherlands

Kim, Yu-chul; Sejong Special Governing City,

Republic of Korea

Lino, Carlos Joaquim Silva; Lisboa, Portugal

Nilsson, Lars; Ronneby, Sweden

Petersson, Jan; Linköping, Sweden

Rochester, Brian L.; Norman, OK, USA

Rosati, Giulio; Rome, Italy

Schilz, Michael T.; Prior Lake, MN, USA

Serur, Steve A.; Arlington, VA, USA

Stueckle, Christian; Munich, Germany

Torvaji, Gabor; Nagykovacsi, Hungary

New Corporate Members

ATR, Blagnac, France

McGregor, Christopher, Flight Safety Officer

Choudet, Marion; Accident/Incident Investigator

Air Asia Group; Sepang, Malaysia

Tien, Ling Liong; Chief Pilot Flight Safety

Hernandez, Johansen; Safety Manager ♦

NEW ISASI Individual and Corporate Members